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Individual
MR. JOE MICHAEL WALLER
Active
Individual
MR. JOE MICHAEL WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
101YS0200X
School Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
419100901
—
TX
Enumeration date
01/20/2021
Last updated
08/15/2022
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