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1598225930
LISA BUCKNER WALLACE
HICKORY, NC
NPI
1598225930
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NC A13854)
Enumeration Date
2019-03-21
Last Update Date
2020-08-11
Business Address
Mrs. LISA BUCKNER WALLACE LCMHCA
3750 N CENTER ST
HICKORY, NC 28601-8089
Phone number: 828-327-3491
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Mailing Address
Mrs. LISA BUCKNER WALLACE LCMHCA
200 E 2ND AVE
GASTONIA, NC 28052-4358
Phone number: 704-874-1900
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