Individual
DESIREE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3310 EASTERN AVE, BALTIMORE, MD 21224-4108
(443) 708-5056
Mailing address
501 SAINT PAUL ST APT 1004, BALTIMORE, MD 21202-2280
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ADT2383
MD
Other
Enumeration date
01/16/2025
Last updated
01/16/2025
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