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Lawanda Wallace
NPI 1144173527 · on the registry since 2026
Practice
- Address
- 4220 N Grand Blvd
Saint Louis, MO 63107 - Phone
- (314) 534-6624
- Clinicians at this address
- 56
Registry record
- Primary taxonomy
- 171M00000X
171M00000X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-02-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri