Individual
ARIANTE VANAE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 MARSHALL ST, SHREVEPORT, LA 71101-4139
(318) 226-9943
Mailing address
501 MATHIES CIR, BARKSDALE AFB, LA 71110-2323
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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