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Individual

MRS. KRYSTAL AMANDA WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15851 DALLAS PKWY STE 600, ADDISON, TX 75001-6030
(214) 785-0147
Mailing address
14132 MALINDA DR, FRISCO, TX 75033-1742

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Enumeration date
01/22/2026
Last updated
01/29/2026
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