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

Juanita Wallace

Individual provider Mental Health Counselor · NPI 1326164278

Juanita Wallace is a Mental Health Counselor in Florissant, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2007
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Practice location Address checks out

570 Shackelford Rd
Florissant, MO 63031-5457
Phone: (314) 583-0549
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 2002006418 (MO)

Record details

NPI number1326164278
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 22, 2007
Last updated in NPPESJuly 9, 2007

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