Individual
MS. DENISE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
661 E MAIN ST, ABINGDON, VA 24210-2339
(276) 623-9245
(276) 623-1183
Mailing address
661 E MAIN ST, ABINGDON, VA 24210-2339
(276) 623-9245
(276) 623-1183
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0904007863
VA
Other
Enumeration date
10/02/2014
Last updated
10/02/2014
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