Stacy Wallace, LCSW

NPI 1225754120 · on the registry since 2022

Practice

Address: 105 Saint Stephens Ct
Tyrone, GA 30290
Phone: (770) 378-9913
Organisation at this address: R&K Medcal Weight Loss Clinic
Precision Pharmaceuticals Llc
Premise Health Of Georgia Medical Pc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2022-10-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia