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Individual
THEODORE EDWIN WALLS
Active
Individual
THEODORE EDWIN WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LMHC, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068.0067951
VT
101YM0800X
Mental Health Counselor
8227
MA
101YP2500X
Professional Counselor
16743
TX
Other
Enumeration date
04/02/2007
Last updated
06/18/2022
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