Lowell Wallace
NPI #1932610623 in Philadelphia, Mississippi
Provider Information
- NPI Number
- 1932610623
- Entity Type
- Individual
- Name
- Lowell Wallace
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Oct 20, 2017
- Last Updated
- Mar 17, 2018
Practice Location
- Address
- 1120 E MAIN ST STE 24
- City
- Philadelphia
- State
- Mississippi
- ZIP Code
- 39350-2300
- Phone
- (601) 781-8677
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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