Wallace, Myisha L
Wallace, Myisha L is an individual health care provider with primary practice located at 13190 Royal Pines Ave , Riverview FL 33579-9321. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Wallace, Myisha L can be contacted via phone (813) 520-0156.Contact Information
Primary practice address
13190 Royal Pines Ave
Riverview FL 33579-9321
Phone: (813) 520-0156
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | IMT3816 | Florida |
Profile Details
| NPI number | 1659062891 |
|---|---|
| LBN Legal business name | Wallace, Myisha L |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2023 |
| Last updated | May 18th, 2023 - about 3 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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