Individual
MISS ALYSEN JANAE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPCA
Contact information
Practice address
9201 UNIVERSITY CITY BLVD, CHARLOTTE, NC 28223-0001
(704) 687-0040
Mailing address
9201 UNIVERSITY CITY BLVD, CHARLOTTE, NC 28223-0001
(704) 687-0040
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A9799
NC
Other
Enumeration date
01/04/2013
Last updated
04/14/2014
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