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

Tara Wallace, LMT, MMP

Individual provider Specialist · NPI 1790124378

Tara Wallace, LMT, MMP is a Specialist in O Fallon, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2013
What do these letters mean?
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

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Practice location Address checks out

2633 Babble Creek Ln
O Fallon, MO 63368-8338
Phone: (636) 577-1216
Fax: (636) 294-0837
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 2001032642 (MO)

Record details

NPI number1790124378
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMT , MMP
Sole proprietorYes
NPI enumeratedJune 18, 2013
Last updated in NPPESJune 18, 2013

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