Individual
MR. DONNIE M. WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
112 MCKINLEY AVE, CHANDLER, OK 74834-1622
(405) 258-3040
(405) 240-5008
Mailing address
RR 2 BOX 220B, MEEKER, OK 74855-9305
(405) 214-9667
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1775
OK
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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