Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

La'Taja Wallace

Individual provider Case Manager/Care Coordinator · NPI 1902351745

La'Taja Wallace is a Case Manager/Care Coordinator in Gautier, Mississippi. Registered with an NPI since 2016.

In the registry since
2016

Practice location Address checks out

3407 Shamrock Ct
Gautier, MS 39553-5337
Phone: (228) 497-0690
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X

Record details

NPI number1902351745
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 22, 2016
Last updated in NPPESAugust 22, 2016

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