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 |