Individual
ALISON QUINN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3 W ALTMAN ST, STATESBORO, GA 30458-5212
(912) 764-2402
(912) 764-5561
Mailing address
3 W ALTMAN ST, STATESBORO, GA 30458-5212
(912) 764-2402
(912) 764-5561
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC008383
GA
Other
Enumeration date
08/29/2012
Last updated
01/29/2019
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