| NPI | 1013064328 |
|---|---|
| Professional Name | BYRON WALLER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180005749) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IL 180005749) |
| 101Y00000X Counselor (Licence: IL 180005749) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2024-05-08 |