person
Tyshaundra Renee Wallace, MED,LCASA,QP
Addiction (Substance Use Disorder) Counselor in High Point, North Carolina
NPI 1669937595

Tyshaundra Renee Wallace is an Addiction (Substance Use Disorder) Counselor based in Reidsville, NC and is specialized in Addiction (Substance Use Disorder). Tyshaundra Renee Wallace practices in High Point, NC and has the professional credentials of MED,LCASA,QP. The NPI Number for Tyshaundra Renee Wallace is 1669937595 and holds a License No. LCAS-25036 (North Carolina).

The current practice location address for Tyshaundra Renee Wallace is 1001 Phillips Ave, High Point, NC and can be reached out via phone at 336-854-2560.

Location: 1001 Phillips Ave, High Point, NC, 27320-9062
person
Provider Profile Details
NPI Number
1669937595
Provider Name
Tyshaundra Renee Wallace
Credential
MED,LCASA,QP
Provider Entity Type
Individual
Gender
Female
Address
1001 Phillips Ave, High Point, NC, 27320-9062
Phone Number
336-854-2560
Fax Number
Provider Enumeration Date
02/05/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1001 Phillips Ave
City
State
Zip
27262-7251
Phone Number
336-854-2560
Fax Number
person
Provider Business Mailing Address Details
Address
1001 Phillips Ave
City
State
Zip
27262-7251
Phone Number
336-854-2560
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
LCAS-25036 (North Carolina)
Definition
Definition to come...
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