Wallace, Mary Etheridge

Wallace, Mary Etheridge is an individual health care provider with primary practice located at 303 E. Main Street Suite 9 , Elizabeth City NC 27909. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Wallace, Mary Etheridge can be contacted via phone (252) 619-6629.

Contact Information

Primary practice address
303 E. Main Street Suite 9 Elizabeth City NC 27909
Phone: (252) 619-6629
Fax: (252) 331-2499
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701005385 Virginia
Behavioral Health & Social Service Providers / Professional 101YP2500X 12837 North Carolina

Profile Details

NPI number 1801136809
LBN Legal business name Wallace, Mary Etheridge
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2013
Last updated Sep 6th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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