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1154477404
MICHAEL WAYNE WALLINGTON
ESPANOLA, NM
NPI
1154477404
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: NM 2331)
Enumeration Date
2007-01-26
Last Update Date
2007-07-08
Business Address
MICHAEL WAYNE WALLINGTON LPCC
904 E FAIRVIEW LN # B
ESPANOLA, NM 87532-2822
Phone number: 505-747-1991
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Mailing Address
MICHAEL WAYNE WALLINGTON LPCC
PO BOX KK
TAOS, NM 87571-1570
Phone number: 505-751-7037
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