Individual
CALVIN RAINFORD WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6500 LAKE PARK DR APT 103, GREENBELT, MD 20770-7001
(240) 535-3066
Mailing address
6500 LAKE PARK DR APT 103, GREENBELT, MD 20770-7001
(240) 535-3066
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC15390
MD
Other
Enumeration date
09/25/2025
Last updated
09/25/2025
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