| NPI | 1982268728 |
|---|---|
| Doing Business As | THERAPY WITH MARIA WALLACE, LCSW, C. HYP. |
| Entity Type | Organization |
| Authorized Contact | MAXINE PREVOST Manager 337-288-8929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2019-04-26 |