Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
JENNIFER LAIRD WALLACE
Active
Individual
JENNIFER LAIRD WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
96257
TX
164W00000X
Licensed Practical Nurse
330403
TX
Other
Enumeration date
06/19/2018
Last updated
07/24/2026
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