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Organization

DANA J. WALLACE, LCSW, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANA JANELLE WALLACE LCSW, LICSW (SOCIAL WORKER/PSYCHTHERAPIST)
(251) 421-0712
Entity
Organization

Contact information

Practice address
480 SANTA ROSA BLVD UNIT 308E, FORT WALTON BEACH, FL 32548-6945
(251) 421-0712
Mailing address
480 SANTA ROSA BLVD UNIT 308E, FORT WALTON BEACH, FL 32548-6945
(251) 421-0712

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
05/14/2026
Last updated
05/14/2026
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