| NPI | 1124253307 |
|---|---|
| Professional Name | J. MARC WALLIS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS19858) |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2009-05-18 |