Shericka Wallace
Counselor in Shreveport, LA. Individual provider (NPI-1).
NPI number1750831277
StatusActive
Last updated in NPPESOct 7, 2016
Details
- NPI
- 1750831277
- Entity type
- Individual (NPI-1)
- Name
- Shericka Wallace
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 7, 2016
- Last updated
- Oct 7, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
1717 Marshall StShreveport, LA 71101-4139
Phone 318-226-9944
Mailing address
1717 Marshall StShreveport, LA 71101-4139
Phone 318-226-9944
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