Individual
MRS. KATRINA LANET WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
2146 24TH PL NE # 2, WASHINGTON, DC 20018-1402
(202) 774-5442
Mailing address
14913 DENNINGTON DR, BOWIE, MD 20721-3273
(301) 351-0984
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
LG50083646
DC
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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