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1851631485
WILLIE JAMES WALLACE
HAMMOND, LA
NPI
1851631485
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: LA 4852)
Enumeration Date
2013-02-19
Last Update Date
2013-02-19
Business Address
Mr. WILLIE JAMES WALLACE LMSW
835 PRIDE DR
HAMMOND, LA 70401-9527
Phone number: 985-543-4730
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Mailing Address
Mr. WILLIE JAMES WALLACE LMSW
835 PRIDE DR
HAMMOND, LA 70401-9527
Phone number: 985-543-4730
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