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1841234101
KERRY L WALLACE
CASSELBERRY, FL
NPI
1841234101
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL MH 5283)
Enumeration Date
2006-06-16
Last Update Date
2007-07-08
Business Address
Prof. KERRY L WALLACE LMHC, NCC
661 SEMINOLA BLVD
CASSELBERRY, FL 32707-3057
Phone number: 407-333-0254
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Mailing Address
Prof. KERRY L WALLACE LMHC, NCC
1841 CROWLEY CIR E
LONGWOOD, FL 32779-7016
Phone number: 407-333-0254
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