person
Mr. Darrell Dewayne Wallace JR., LGPC
Mental Health Counselor in Baltimore, Maryland
NPI 1265086367

Darrell Dewayne Wallace JR. is a Mental Health Counselor based in Millersville, MD and is specialized in Mental Health. Darrell Dewayne Wallace JR. practices in Baltimore, MD and has the professional credentials of LGPC. The NPI Number for Darrell Dewayne Wallace JR. is 1265086367 and holds a License No. LGP9687 (Maryland).

The current practice location address for Darrell Dewayne Wallace JR. is 107 E 25Th St, Baltimore, MD and can be reached out via phone at 410-558-0019.

Location: 107 E 25Th St, Baltimore, MD, 21108-1525
person
Provider Profile Details
NPI Number
1265086367
Provider Name
Darrell Dewayne Wallace JR.
Credential
LGPC
Provider Entity Type
Individual
Gender
Male
Address
107 E 25Th St, Baltimore, MD, 21108-1525
Phone Number
410-558-0019
Fax Number
Provider Enumeration Date
07/26/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
107 E 25Th St
City
State
Zip
21218-5213
Phone Number
410-558-0019
Fax Number
person
Provider Business Mailing Address Details
Address
107 E 25Th St
City
State
Zip
21218-5213
Phone Number
410-558-0019
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LGP9687 (Maryland)
Definition
Definition to come...
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