person
Juanita Wallace
Mental Health Counselor in Florissant, Missouri
NPI 1326164278

Juanita Wallace is a Mental Health Counselor based in Florissant, MO and is specialized in Mental Health. Juanita Wallace practices in Florissant, MO. The NPI Number for Juanita Wallace is 1326164278 and holds a License No. 2002006418 (Missouri).

The current practice location address for Juanita Wallace is 570 Shackelford Rd, Florissant, MO and can be reached out via phone at 314-583-0549. You can also correspond with Juanita Wallace through the mailing address at 570 SHACKELFORD RD, FLORISSANT, MO - 63031-5457 (mailing address contact number: 314-583-0549).

Location: 570 Shackelford Rd, Florissant, MO, 63031-5457
person
Provider Profile Details
NPI Number
1326164278
Provider Name
Juanita Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
570 Shackelford Rd, Florissant, MO, 63031-5457
Phone Number
314-583-0549
Fax Number
Provider Enumeration Date
03/22/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
570 Shackelford Rd
City
State
Zip
63031-5457
Phone Number
314-583-0549
Fax Number
person
Provider Business Mailing Address Details
Address
570 Shackelford Rd
City
State
Zip
63031-5457
Phone Number
314-583-0549
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
2002006418 (Missouri)
Definition
Definition to come...
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