Judith Wallace, MAC, LAT

NPI #1205373107 in Sheridan, Wyoming

Provider Information

NPI Number: 1205373107
Entity Type: Individual
Name: Judith Wallace, MAC, LAT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: MAC, LAT
Enumeration Date: Jan 30, 2017
Last Updated: Jan 30, 2026

Practice Location

Address: 1221 W 5TH ST
City: Sheridan
State: Wyoming
ZIP Code: 82801-2701
Phone: (307) 674-4405

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Acupuncturist	171100000X
Counselor - Professional — Professional	101YP2500X	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Mental Health — Mental Health	101YM0800X

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