Search › Texas › 1041C0700X
Lisa Wallace, LCSW, LCDC
NPI 1760958458 · on the registry since 2018 · sole proprietor
Practice
- Address
- 2903 Gabriel View Dr
Georgetown, TX 78628 - Phone
- (512) 869-9254
- Fax
- (512) 863-6833
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 101YA0400X
- Licence states on file
- TX
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-10-28
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 Texas