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Individual

ROSALIND WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PLMSW

Contact information

Practice address
620 S LAUREL ST, PINE BLUFF, AR 71601-4859
(870) 534-4900
(870) 534-4906
Mailing address
620 S LAUREL ST, PINE BLUFF, AR 71601-4859
(870) 534-4900
(501) 534-4906

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
AR
171M00000X
Case Manager/Care Coordinator
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
180635526
AR
Enumeration date
06/04/2020
Last updated
06/12/2023
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