Individual
DONNA K WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1901 S 24TH AVE, EDINBURG, TX 78539-6533
(956) 289-7000
(956) 289-7257
Mailing address
5 BOCA CHICA BLVD STE 5, BROWNSVILLE, TX 78520-7863
(956) 289-7000
(956) 289-7025
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
18857
TX
Other
Enumeration date
07/24/2007
Last updated
07/24/2007
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