Individual
DANA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
15 NORTON HTS, WOLCOTT, CT 06716-1644
(203) 525-9842
Mailing address
15 NORTON HTS, WOLCOTT, CT 06716-1644
(203) 525-9842
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5709
CT
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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