Individual
MS. MARIA HEBERT WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
345 DOUCET RD STE 228, LAFAYETTE, LA 70503-3490
(337) 281-1121
Mailing address
207 WAVERLY BLVD, LAFAYETTE, LA 70508-8091
(337) 281-1121
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8956
LA
Other
Enumeration date
04/26/2010
Last updated
03/07/2019
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