Individual
MAX WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
716 ADAMS ST, NEW ORLEANS, LA 70118-3931
(504) 446-6212
Mailing address
7809 HICKORY ST, NEW ORLEANS, LA 70118-4126
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16308
LA
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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