JON WALLER

TAMARAC, FL
NPI1790331270
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101Y00000X Counselor
(Licence: FL  MH12508)
Enumeration Date2019-08-12
Last Update Date2019-08-12
Business Address
JON WALLER LMHC
4800 W COMMERCIAL BLVD
TAMARAC, FL 33319-2879
Phone number: 954-300-3244
Mailing Address
JON WALLER LMHC
925 INTRACOASTAL DR APT 8
FORT LAUDERDALE, FL 33304-3688
Phone number: 352-246-4027