Individual
WILLIAM W WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPH, MHFA
Contact information
Practice address
806 S TEJON ST, COLORADO SPRINGS, CO 80903-4149
(501) 231-8132
Mailing address
14540 ROSHOLT LOOP, COLORADO SPRINGS, CO 80921-2000
(501) 231-8132
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
STUDENT2026
CO
Other
Enumeration date
11/03/2025
Last updated
11/03/2025
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