Individual
MYLES JAMAR WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1426 E MAIN ST, ALBEMARLE, NC 28001-5236
(704) 982-0950
Mailing address
2405 TWINBERRY LN, WAXHAW, NC 28173-6861
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
NC
Other
Enumeration date
01/15/2026
Last updated
01/15/2026
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