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1306224613
TRACIE WALLACE
SAINT LOUIS, MO
NPI
1306224613
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: MO 2012029763)
Enumeration Date
2015-05-07
Last Update Date
2015-05-07
Business Address
-- TRACIE WALLACE LPC
1023 EXECUTIVE PARKWAY DR STE 10
SAINT LOUIS, MO 63141-6323
Phone number: 314-469-5522
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Mailing Address
-- TRACIE WALLACE LPC
1023 EXECUTIVE PARKWAY DR STE 10
SAINT LOUIS, MO 63141-6323
Phone number: 314-469-5522
Copy
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