FORMECIA WALLACE MS, MA, LCAS-A ⚕️ North Carolina 1518423045

NPI	1518423045
Entity Type	Individual
Gender	Female
Sole Proprietor ?	No
Primary Taxonomy	101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 25169)
Enumeration Date	2019-02-20
Last Update Date	2019-03-05

FORMECIA WALLACE MS, MA, LCAS-A

618 E BOULEVARD

WILLIAMSTON, NC 27892-2736

Phone number: 252-792-0659

FORMECIA WALLACE MS, MA, LCAS-A

1070 WYNN RD

WILLIAMSTON, NC 27892-8844

Phone number: 252-864-6835