Darre'll J Wallace
NPI #1003321720 in Shreveport, Louisiana
Provider Information
- NPI Number
- 1003321720
- Entity Type
- Individual
- Name
- Darre'll J Wallace
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Dec 4, 2017
- Last Updated
- Dec 4, 2017
Practice Location
- Address
- 1711 MARSHALL ST
- City
- Shreveport
- State
- Louisiana
- ZIP Code
- 71101-4139
- Phone
- (318) 226-9944
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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