Wallace, Lisa

Wallace, Lisa is an sole proprietor health care provider with primary practice located at 2903 Gabriel View Dr , Georgetown TX 78628-2707. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Wallace, Lisa can be contacted via phone (512) 869-9254.

Contact Information

Primary practice address
2903 Gabriel View Dr Georgetown TX 78628-2707
Phone: (512) 869-9254
Fax: (512) 863-6833
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 58545 Texas
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 12442 Texas

Profile Details

NPI number 1760958458
LBN Legal business name Wallace, Lisa
Credentials LCSW, LCDC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 19th, 2018
Last updated Oct 28th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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