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1114990900
STACEY WALLER
CHARLESTON, WV
NPI
1114990900
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: WV 891)
Enumeration Date
2006-02-10
Last Update Date
2008-06-04
Business Address
-- STACEY WALLER Ph.D.
1097 FLEDDERJOHN RD STE 3
CHARLESTON, WV 25314-4208
Phone number: 304-345-0880
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Mailing Address
-- STACEY WALLER Ph.D.
1097 FLEDDERJOHN RD STE 3
CHARLESTON, WV 25314-4208
Phone number: 304-345-0880
Copy
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