Individual
AMANDA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC-S
Contact information
Practice address
1 PERKINS SQ, AKRON, OH 44308-1063
(330) 543-5015
(330) 543-3942
Mailing address
464 S HAWKINS AVE, AKRON, OH 44320-1228
(330) 434-2343
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E.1000654
OH
Other
Enumeration date
01/22/2014
Last updated
05/20/2020
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