Individual
PHILLIP WALLECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
174 WATERCOLOR WAY # 103-238, SANTA ROSA BEACH, FL 32459-7350
(850) 660-8353
Mailing address
174 WATERCOLOR WAY # 103-238, SANTA ROSA BEACH, FL 32459-7350
(850) 660-8353
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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