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

Desiree Wallace

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1104637461

Desiree Wallace is an Addiction (Substance Use Disorder) Counselor in Baltimore, Maryland. Licensed in Maryland. Registered with an NPI since 2025.

Licensed in
MD
In the registry since
2025

Practice location Address checks out

3310 Eastern Ave
Baltimore, MD 21224-4108
Phone: (443) 708-5056
Show map & directions

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

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence ADT2383 (MD)

Record details

NPI number1104637461
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 16, 2025
Last updated in NPPESJanuary 16, 2025
Certification dateJanuary 16, 2025

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