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Individual
JOYCE W WALLACE
Active
Individual
JOYCE W WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LISW-CP
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C010071
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3000641104
WORKER'S COMP
SC
05
—
322842
—
SC
Enumeration date
08/12/2009
Last updated
02/17/2017
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