Individual
MRS. AMBER WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
9171 COCKERHAM RD, DENHAM SPRINGS, LA 70726-2255
(225) 924-1910
Mailing address
9171 COCKERHAM RD, DENHAM SPRINGS, LA 70726-2255
(225) 924-1910
(225) 924-1910
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5772
LA
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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