Individual
NYESHA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 POST OAK BLVD STE 600, HOUSTON, TX 77056-3973
(800) 892-2695
Mailing address
2960 CAMINO DIABLO, STE 105, WALNUT CREEK, CA 94597-3945
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
15286
TX
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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