Individual
LEAH JO WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
915 HIGHWAY 84 W, CARUTHERSVILLE, MO 63830-8113
(573) 333-5975
Mailing address
935 STATE ROUTE VV, KENNETT, MO 63857-3822
(573) 888-5925
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/12/2021
Last updated
10/16/2023
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