Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Andrea Michelle Wallace

Individual provider Peer Specialist · NPI 1790654168

Andrea Michelle Wallace is a Peer Specialist in Lawton, Oklahoma. Works from 2 locations. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2025

Practice location Address checks out

2 SE Lee Blvd
Lawton, OK 73501-2409
Phone: (580) 248-5780
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 602 Sw 38th St, Lawton, OK 73505-6912 — (580) 248-5780

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X (OK)

Record details

NPI number1790654168
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 3, 2025
Last updated in NPPESNovember 7, 2025
Certification dateNovember 3, 2025

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