Individual
MS. MARGARET ANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8626 AIRWAYS BLVD, SOUTHAVEN, MS 38671-2603
(662) 772-5937
(662) 772-5940
Mailing address
8626 AIRWAYS BLVD, SOUTHAVEN, MS 38671-2603
(662) 772-5937
(662) 772-5940
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C7663
MS
Other
Enumeration date
09/23/2009
Last updated
10/11/2021
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