Individual
DR. CYNTHIA LEWIS WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2817 REILLY ST, FORT BRAGG, NC 28310-1078
(910) 907-6999
Mailing address
112 EVANS CREST LN, HOLLY SPRINGS, NC 27540-6181
(440) 503-7071
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005436
VA
103TC0700X
Clinical Psychologist
5096
NC
Other
Enumeration date
05/24/2016
Last updated
10/13/2021
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