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Individual

MS. MARCY MARIE WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LSSP, PA

Contact information

Practice address
14340 TORREY CHASE BLVD STE 160, HOUSTON, TX 77014-1040
(281) 580-8086
(281) 580-7129
Mailing address
14340 TORREY CHASE BLVD STE 160, HOUSTON, TX 77014-1040
(281) 580-8086
(281) 580-7129

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
30544
TX

Other

Enumeration date
08/13/2010
Last updated
08/13/2010
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