person
Mrs. Myriah Dawn Wallace, LPC
Professional Counselor in West Plains, Missouri
NPI 1184921496

Myriah Dawn Wallace is a Professional Counselor based in West Plains, MO and is specialized in Professional. Myriah Dawn Wallace practices in West Plains, MO and has the professional credentials of LPC. The NPI Number for Myriah Dawn Wallace is 1184921496 and holds a License No. 2011008967 (Missouri).

The current practice location address for Myriah Dawn Wallace is 1211 Porter Wagoner Blvd, West Plains, MO and can be reached out via phone at 417-257-6762 and via fax at 417-257-5875.

Location: 1211 Porter Wagoner Blvd, West Plains, MO, 65775-1100
person
Provider Profile Details
NPI Number
1184921496
Provider Name
Myriah Dawn Wallace
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
1211 Porter Wagoner Blvd, West Plains, MO, 65775-1100
Phone Number
417-257-6762
Fax Number
417-257-5875
Provider Enumeration Date
02/23/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2011008967 05 MO
institution
Provider Business Practice Location Address Details
Address
1211 Porter Wagoner Blvd
City
State
Zip
65775-1826
Phone Number
417-257-6762
Fax Number
417-257-5875
person
Provider Business Mailing Address Details
Address
1211 Porter Wagoner Blvd
City
State
Zip
65775-1826
Phone Number
417-257-6762
Fax Number
417-257-5875
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
2011008967 (Missouri)
Definition
Definition to come...
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