Wallace, Raychelle Sheryl

Wallace, Raychelle Sheryl is an sole proprietor health care provider with primary practice located at 673 W Lumsden Rd , Brandon FL 33511-5911. She recently has 6 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Agencies / Case Management, Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Wallace, Raychelle Sheryl can be contacted via phone (813) 798-0800.

Contact Information

Primary practice address
673 W Lumsden Rd Brandon FL 33511-5911
Phone: (813) 798-0800
Fax: (813) 798-7800
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X IMH18337 Florida
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X IMH18337 Florida
Agencies / Case Management 251B00000X IMH18337 Florida
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X IMH18337 Florida
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X IMH18337 Florida
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH19813 Florida

Profile Details

NPI number 1609464098
LBN Legal business name Wallace, Raychelle Sheryl
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 2nd, 2021
Last updated Aug 14th, 2023 - about 2 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.

Request for update

Popular Providers