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Individual

ANZIA TIMMONS WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
STUDENT COUNSELOR

Contact information

Practice address
1800 2ND LOOP RD STE 3&4, FLORENCE, SC 29501-6180
(843) 667-1905
Mailing address
2109 LOQUAT DR, FLORENCE, SC 29505-3806

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
106H00000X
Marriage & Family Therapist
Primary

Other

Enumeration date
05/24/2021
Last updated
05/24/2021
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