Individual
CYNTHIA C WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCMHCS, NCC
Contact information
Practice address
322 LAMAR AVE STE 209, CHARLOTTE, NC 28204-2436
(704) 477-6044
Mailing address
322 LAMAR AVE STE 209, CHARLOTTE, NC 28204-2436
(704) 477-6044
(704) 477-6044
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
S6946
NC
Other
Enumeration date
10/02/2021
Last updated
10/02/2021
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