person
Mrs. Bonita Lucille Wallace, LPC
Professional Counselor in Atlanta, Georgia
NPI 1912364787

Bonita Lucille Wallace is a Professional Counselor based in Atlanta, GA and is specialized in Professional. Bonita Lucille Wallace practices in Atlanta, GA and has the professional credentials of LPC. The NPI Number for Bonita Lucille Wallace is 1912364787 and holds a License No. 1823 (Georgia).

The current practice location address for Bonita Lucille Wallace is 550 Pharr Rd Ne, Atlanta, GA and can be reached out via phone at 404-664-6398 and via fax at 678-705-2758.

Location: 550 Pharr Rd Ne, Atlanta, GA, 30305-3428
person
Provider Profile Details
NPI Number
1912364787
Provider Name
Bonita Lucille Wallace
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
550 Pharr Rd Ne, Atlanta, GA, 30305-3428
Phone Number
404-664-6398
Fax Number
678-705-2758
Provider Enumeration Date
01/25/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
550 Pharr Rd Ne
City
State
Zip
30305-3428
Phone Number
404-664-6398
Fax Number
678-705-2758
person
Provider Business Mailing Address Details
Address
550 Pharr Rd Ne
City
State
Zip
30305-3428
Phone Number
404-664-6398
Fax Number
678-705-2758
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
1823 (Georgia)
Definition
Definition to come...
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