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1841656311
MELISSA EMILY WALLACE
LAKELAND, FL
NPI
1841656311
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Former Name
MELISSA EMILY MARTINEZ
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: FL SW17470)
Enumeration Date
2016-01-13
Last Update Date
2023-02-15
Business Address
MELISSA EMILY WALLACE LCSW
1473 CYPRESS VIEW LN
LAKELAND, FL 33811-2689
Phone number: 863-899-7613
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Mailing Address
MELISSA EMILY WALLACE LCSW
6700 S FLORIDA AVE STE 33
LAKELAND, FL 33813-3312
Phone number: 863-450-3067
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