Individual
MR. JOSEPH CHRISTOPHER WALLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
8800 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87111
(505) 462-6400
(505) 462-6565
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-2023-0019
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85639729
—
NM
Enumeration date
08/15/2012
Last updated
07/05/2023
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