SearchLouisiana343900000X

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