| Doctor Name: | LOU ANN CAREY WALLACE |
| NPI Number: | 1063742922 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SR. PSYC. EXAMINER |
| License Number: | PE0000001013 |
| Business Practice Address: | 35 Jeannie Belle Yarboro Rd Parsons, TN - 383633305 |
| Business Phone Number: | 7315494382 |
| Business Fax Number: | |
| Mailing Address: | Po Box 205, PARSONS |
| State: | TN |
| Postal Code: | 383630205 |
| Phone Number: | 7315494382 |
| Fax Number: | |
| NPI Enumeration Date: | 12/28/2009 |
| NPI Last Update Date: | 12/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PE0000001013 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |