| Mrs Myriah Dawn Wallace, LPC | |
|
1211 Porter Wagoner Blvd, West Plains, MO 65775-1826 | |
| (417) 257-6762 | |
| (417) 257-5875 |
| Full Name | Mrs Myriah Dawn Wallace |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 1211 Porter Wagoner Blvd, West Plains, Missouri |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184921496 | NPI | - | NPPES |
| 2011008967 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2011008967 (Missouri) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Myriah Dawn Wallace, LPC Po Box 1100, West Plains, MO 65775-1100 Ph: (417) 257-6762 | Mrs Myriah Dawn Wallace, LPC 1211 Porter Wagoner Blvd, West Plains, MO 65775-1826 Ph: (417) 257-6762 |
Jenna Hampton, PLPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1211 Porter Wagoner Blvd, West Plains, MO 65775 Phone: 417-257-6762 | |
Mrs. Jeannie Rhoads-ashley, CCDP Counselor Medicare: Not Enrolled in Medicare Practice Location: 1015 Lanton Rd, West Plains, MO 65775 Phone: 417-256-2570 Fax: 417-256-6497 | |
Cretia Lynne Ussery, QMHP RADC-P Counselor Medicare: Not Enrolled in Medicare Practice Location: 1015 Lanton Rd, West Plains, MO 65775 Phone: 417-257-9152 | |
Rebecca Kay Beville, MA, QMHP Counselor Medicare: Medicare Enrolled Practice Location: 1211 Porter Wagoner Blvd, West Plains, MO 65775 Phone: 417-257-6762 | |
Kendell Pellham, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1015 Lanton Rd, West Plains, MO 65775 Phone: 417-256-2570 | |
Tabatha Diane Wade, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1137 Independence Dr, West Plains, MO 65775 Phone: 417-255-8703 | |
Mrs. Wendra L Dunkin, CSAC II Counselor Medicare: Not Enrolled in Medicare Practice Location: 1015 Lanton Rd, West Plains, MO 65775 Phone: 417-256-2570 Fax: 417-256-6497 |