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1710521968
LISA ANNE WALLACE
LEXINGTON, SC
NPI
1710521968
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: SC 7291)
Enumeration Date
2019-10-31
Last Update Date
2019-10-31
Business Address
LISA ANNE WALLACE MA, LPC, NCC, CCNHC
418 BARR RD
LEXINGTON, SC 29072-2363
Phone number: 803-707-4945
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Mailing Address
LISA ANNE WALLACE MA, LPC, NCC, CCNHC
300 PALMETTO PARK BLVD APT 216
LEXINGTON, SC 29072-7877
Phone number: 803-707-4945
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