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1821874389
LULA WALLACE
BALTIMORE, MD
NPI
1821874389
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MD ACO333)
Enumeration Date
2023-08-31
Last Update Date
2023-08-31
Business Address
LULA WALLACE CAC-AD
821 N EUTAW ST
BALTIMORE, MD 21201-4648
Phone number: 410-225-9185
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Mailing Address
LULA WALLACE CAC-AD
4108 FALLSTAFF RD
BALTIMORE, MD 21215-1411
Phone number: 443-660-9929
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