Tracy Wallace, LGPC
NPI #1366229874 in Lutherville Timonium, Maryland
Provider Information
- NPI Number
- 1366229874
- Entity Type
- Individual
- Name
- Tracy Wallace, LGPC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Professional
- Credential
- LGPC
- Enumeration Date
- Sep 11, 2023
- Last Updated
- Sep 11, 2023
Practice Location
- Address
- 9475 DEERECO RD STE 410
- State
- Maryland
- ZIP Code
- 21093-2124
- Phone
- (410) 560-6135
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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