| Doctor Name: | MRS. SYLVIA S. WALLACE |
| NPI Number: | 1104882612 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.ED., L.P.C. |
| License Number: | 2453 |
| Business Practice Address: | 315 N Cedar St Lincolnton, NC - 280922802 |
| Business Phone Number: | 7047369373 |
| Business Fax Number: | |
| Mailing Address: | 529 Jacob Trl, LINCOLNTON |
| State: | NC |
| Postal Code: | 280928518 |
| Phone Number: | 7047369373 |
| Fax Number: | |
| NPI Enumeration Date: | 04/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2453 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |