person
Kathi Wallace, LCPC
Professional Counselor in Maryville, Illinois
NPI 1114319092

Kathi Wallace is a Professional Counselor based in Glen Carbon, IL and is specialized in Professional. Kathi Wallace practices in Maryville, IL and has the professional credentials of LCPC. The NPI Number for Kathi Wallace is 1114319092 and holds a License No. 2013036985 (Illinois).

The current practice location address for Kathi Wallace is 5 Schiber Ct Ste D, Maryville, IL and can be reached out via phone at 314-626-4285.

Location: 5 Schiber Ct Ste D, Maryville, IL, 62034-1477
person
Provider Profile Details
NPI Number
1114319092
Provider Name
Kathi Wallace
Credential
LCPC
Provider Entity Type
Individual
Gender
Female
Address
5 Schiber Ct Ste D, Maryville, IL, 62034-1477
Phone Number
314-626-4285
Fax Number
Provider Enumeration Date
03/02/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
5 Schiber Ct Ste D
City
State
Zip
62062-5606
Phone Number
314-626-4285
Fax Number
person
Provider Business Mailing Address Details
Address
5 Schiber Ct Ste D
City
State
Zip
62062-5606
Phone Number
314-626-4285
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
2013036985 (Missouri)
Definition
Definition to come...
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