| NPI | 1407888621 |
|---|---|
| Other Name | KATHY WALLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: ND 1826) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ND 1593) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2016-01-19 |