Most Relevant Information
Provider Data
| NPI Number: | 1003016320 |
| Provider Name: | DONNA K WALLACE |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 18857 |
Most Important Dates
| Enumeration Date: | 07/24/2007 |
| Last Updated: | 07/24/2007 |
Provider Practice Location
1901 S 24TH AVE
EDINBURG
TX
785396533
Practice Location Phone/Fax
| Phone: | 9562897000 |
| Fax: | 9562897257 |
Provider Mailing Location
5 BOCA CHICA BLVD STE 5
BROWNSVILLE
TX
785207863
Provider Mailing Phone/Fax
| Phone: | 9562897000 |
| Fax: | 9562897025 |