Individual
WALLACE WILLIAM VARONKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
30 TAUNTON GREENE SUITE 5, TAUNTON, MA 02780
(508) 880-6666
(508) 880-6655
Mailing address
78 BOLAS ROAD, DUXBURY, MA 02332
(781) 582-3838
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
4573
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1311778
—
MA
Enumeration date
09/25/2006
Last updated
07/09/2007
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