OrganizationMaria Wallace Rapid Transformational TherapistSocial WorkerBehavioral Health & Social Service ProvidersPractice Address345 Doucet Rd Ste 228, Lafayette, LA 70503-3490(337) 281-1121PECOS EnrollmentBased on the most recent information from CMS, provider Maria Wallace Rapid Transformational Therapist does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1982268728Provider TypeOrganizationFull NameMaria Wallace Rapid Transformational TherapistSubpartNoEnumeration Date4/26/2019Last Updated4/26/2019Contact InformationPractice LocationPractice Address345 Doucet Rd Ste 228, Lafayette, LA 70503-3490Phone(337) 281-1121FaxUnlisted FaxMailing LocationMailing Address207 Waverly Blvd, Lafayette, LA 70508-8091Phone(337) 281-1121FaxUnlisted FaxAuthorized OfficialNamePrevost, Maxine (Manager)Phone(337) 288-8929Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer