Wallace, Tonyatta
Wallace, Tonyatta is an individual health care provider with primary practice located at 30826 Linder Rd , Denham Springs LA 70726-8507. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Wallace, Tonyatta can be contacted via phone (225) 665-7878.Contact Information
Primary practice address
30826 Linder Rd
Denham Springs LA 70726-8507
Phone: (225) 665-7878
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1790130615 |
|---|---|
| LBN Legal business name | Wallace, Tonyatta |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 28th, 2016 |
| Last updated | Apr 28th, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790130615 | NPPES |
| Louisiana | MEDICAID | 1548839 |
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