Mellani Maritza Wallace
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 RdBrandon, MS 39042-3038
Phone: (601) 591-5553
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Counselor (primary) | Taxonomy 101Y00000X |
|---|
Record details
| NPI number | 1033799499 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | April 10, 2021 |
| Last updated in NPPES | April 10, 2021 |
| Certification date | April 10, 2021 |
| Mailing address | 5749 Raymond Bolton Rd, Bolton, MS 39041-9253 |
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