MRS. Patricia Irene Wallace, LPC,LADC

NPI #1043336704 in Hugo, Oklahoma

Provider Information

NPI Number: 1043336704
Entity Type: Individual
Name: MRS. Patricia Irene Wallace, LPC,LADC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Credential: LPC,LADC
Enumeration Date: Mar 22, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 104 N 4TH ST
City: Hugo
State: Oklahoma
ZIP Code: 74743-4003
Phone: (580) 326-7531

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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