Individual
LUCY G WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
159 EXECUTIVE DR STE A, DANVILLE, VA 24541-4160
(434) 799-7732
Mailing address
1212 FRIENDSHIP CHURCH RD, DRAKES BRANCH, VA 23937-2307
(434) 414-4612
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202010643
VA
Other
Enumeration date
04/25/2023
Last updated
04/25/2023
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