Individual
JOCELYN JONES WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A, LPC-A
Contact information
Practice address
1203 KENT RD, RALEIGH, NC 27606-1977
(919) 797-9544
(919) 803-0992
Mailing address
108 MARYLAND DR, LA GRANGE, NC 28551-9107
(919) 223-3202
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20038
NC
101YP2500X
Professional Counselor
A10754
NC
Other
Enumeration date
02/06/2014
Last updated
03/24/2014
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