Individual
MRS. MARIA WALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
8792 COUNTY ROAD 135, KAUFMAN, TX 75142-5872
(214) 244-0504
Mailing address
8792 COUNTY ROAD 135, KAUFMAN, TX 75142-5872
(214) 244-0504
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11038
TX
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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