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Tierney Wallace
NPI 1578270955 · on the registry since 2022 · sole proprietor
Practice
- Address
- 5455 Satinwood Dr
Baton Rouge, LA 70812 - Phone
- (225) 907-8603
Registry record
- Primary taxonomy
- 343900000X
343900000X
- Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-11-03
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 Louisiana