Search › North Carolina › 101YA0400X
Formecia Wallace, MS, MA, LCAS-A
NPI 1518423045 · on the registry since 2019
Practice
- Address
- 618 E Boulevard
Williamston, NC 27892 - Phone
- (252) 792-0659
- Fax
- (252) 792-0660
- Organisation at this address
- Milestone Innovative Services
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Licence states on file
- NC
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2019-03-05
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 North Carolina