Individual
TRIPHINIA M WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.
Contact information
Practice address
4062 PEACHTREE RD NE # 190A, BROOKHAVEN, GA 30319-3021
(404) 317-2283
(404) 393-6692
Mailing address
4062 PEACHTREE RD NE # 190A, BROOKHAVEN, GA 30319-3021
(404) 317-2283
(404) 393-6692
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
GA003723
GA
Other
Enumeration date
03/09/2007
Last updated
03/14/2025
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