| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LUCY WALLACE | 1679189161 | 2020-09-20 |
Lucy Wallace is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1679189161. Registration indicates Lucy Wallace is a provider of services with a specialization in Behavioral Health & Social Service Providers, Marriage & Family Therapist (Marriage & Family Therapist, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Marriage & Family Therapist, Behavioral Health & Social Service Providers)
| Entity Type | Individual |
| Provider Name | Lucy Wallace |
| Practice Office Address | 6540 LUSK BLVD STE C227 SAN DIEGO, CA US |
| Practice Office Telephone | 6198250499 |
| Mailing Address | 6540 LUSK BLVD STE C227 SAN DIEGO, CA 921212782 US |
| Business Telephone | 6198250499 |
| Direct Messaging Address [] | [email protected] | Direct |
| Code | Practice | License No State |
|---|---|---|
| 106H00000X PRIMARY | Behavioral Health & Social Service Providers Marriage & Family Therapist Marriage & Family Therapist Behavioral Health/Substance Abuse/Psychiatry Marriage & Family Therapist Behavioral Health & Social Service Providers | 121771
CA |
| NA | OTHER | NA |