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

Mellani Maritza Wallace

Individual provider Counselor · NPI 1033799499

Mellani Maritza Wallace is a Counselor in Brandon, Mississippi. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

613 Marquette Rd
Brandon, MS 39042-3038
Phone: (601) 591-5553
Show map & directions

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

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X

Record details

NPI number1033799499
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 10, 2021
Last updated in NPPESApril 10, 2021
Certification dateApril 10, 2021
Mailing address5749 Raymond Bolton Rd, Bolton, MS 39041-9253

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