Mary Etheridge Wallace, LPC
NPI #1801136809 in Elizabeth City, North Carolina
Provider Information
- NPI Number
- 1801136809
- Entity Type
- Individual
- Name
- Mary Etheridge Wallace, LPC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Professional
- Credential
- LPC
- Enumeration Date
- Feb 27, 2013
- Last Updated
- Sep 6, 2018
Practice Location
- Address
- 303 E. MAIN STREET SUITE 9
- City
- Elizabeth City
- State
- North Carolina
- ZIP Code
- 27909
- Phone
- (252) 619-6629
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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