MS. Deborah Faye Wallace, LCPC LICENSED CLINIC
NPI #1235999293 in Carlinville, Illinois
Provider Information
- NPI Number
- 1235999293
- Entity Type
- Individual
- Name
- MS. Deborah Faye Wallace, LCPC LICENSED CLINIC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Professional
- Credential
- LCPC LICENSED CLINIC
- Enumeration Date
- Mar 19, 2024
- Last Updated
- Mar 19, 2024
Practice Location
- Address
- 18772 RT. 4
- City
- Carlinville
- State
- Illinois
- ZIP Code
- 62626
- Phone
- (217) 854-2712
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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