Individual
DIONNE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 AUBURN AVE, LAFAYETTE, LA 70503-2308
(337) 261-2300
(337) 261-9080
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
(318) 459-6795
(318) 626-5429
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
IC-1329
NV
Other
Enumeration date
06/06/2011
Last updated
05/30/2024
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