Individual
MRS. ELIZABETH DASHIELL WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LPC
Contact information
Practice address
429 N CHURCH ST, SPARTANBURG, SC 29303-3612
(864) 597-4371
(864) 597-4379
Mailing address
360 E KILLARNEY LK, MOORE, SC 29369-9489
(864) 804-8381
(864) 804-8381
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4656
SC
Other
Enumeration date
03/05/2009
Last updated
03/05/2009
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