Individual
SHANNON E WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7490 BROMPTON ST APT 371, HOUSTON, TX 77025-2281
(727) 810-5166
Mailing address
7490 BROMPTON ST APT 371, HOUSTON, TX 77025-2281
(727) 810-5166
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
251K00000X
Public Health or Welfare Agency
—
—
374J00000X
Doula
Primary
—
—
Other
Enumeration date
08/16/2023
Last updated
08/16/2023
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