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1780930370
AMY WALLIS
MOORE, OK
NPI
1780930370
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OK 6156)
Enumeration Date
2012-08-01
Last Update Date
2023-02-22
Business Address
AMY WALLIS LPC
620 NW 5TH ST STE D
MOORE, OK 73160-3947
Phone number: 405-208-4469
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Mailing Address
AMY WALLIS LPC
620 NW 5TH ST STE D
MOORE, OK 73160-3947
Phone number: 405-208-4469
Copy
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