Individual
ALYSSA MARIE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1045 JAMES ST STE 100, SYRACUSE, NY 13203-2758
(315) 425-1004
(315) 479-7884
Mailing address
1045 JAMES ST STE 100, SYRACUSE, NY 13203-2758
(315) 425-1004
(315) 479-7884
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
01699
NY
Other
Enumeration date
09/23/2020
Last updated
05/01/2023
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