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Mellani Maritza Wallace
Counselor in Brandon, Mississippi
NPI 1033799499

Mellani Maritza Wallace is a Counselor based in Bolton, MS. Mellani Maritza Wallace practices in Brandon, MS. The NPI Number for Mellani Maritza Wallace is 1033799499 and holds a License No. (Mississippi).

The current practice location address for Mellani Maritza Wallace is 613 Marquette Rd, Brandon, MS and can be reached out via phone at 601-591-5553.

Location: 613 Marquette Rd, Brandon, MS, 39041-9253
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033799499
Provider Name
Mellani Maritza Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
613 Marquette Rd, Brandon, MS, 39041-9253
Phone Number
601-591-5553
Fax Number
Provider Enumeration Date
04/10/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
613 Marquette Rd
City
Brandon
State
Mississippi
Zip
39042-3038
Phone Number
601-591-5553
Fax Number
person
Provider Business Mailing Address Details
Address
613 Marquette Rd
City
Brandon
State
Mississippi
Zip
39042-3038
Phone Number
601-591-5553
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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