Individual
HELEN WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
12080 MENDEL DR, ORLANDO, FL 32826
(386) 631-1793
Mailing address
12080 MENDEL DR, ORLANDO, FL 32826-2288
(386) 631-1793
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1690461740
—
FL
Enumeration date
10/03/2014
Last updated
10/03/2014
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