Organization
MARIA WALLACE RAPID TRANSFORMATIONAL THERAPIST
Active
Other names
Therapy with Maria Wallace, LCSW, C. Hyp.
Organization subpart
No
Provider details
NPI number
Authorized official
MAXINE PREVOST (MANAGER)
(337) 288-8929
Entity
Organization
Contact information
Practice address
345 DOUCET RD STE 228, LAFAYETTE, LA 70503-3490
(337) 281-1121
Mailing address
207 WAVERLY BLVD, LAFAYETTE, LA 70508-8091
(337) 281-1121
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/26/2019
Last updated
04/26/2019
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