Individual
DR. AARON LEE WALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
13520 ROAD 42, MANCOS, CO 81328-9046
(210) 380-8200
Mailing address
13520 ROAD 42, MANCOS, CO 81328-9046
(210) 380-8200
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY.0004513
CO
103TC1900X
Counseling Psychologist
PSY.0004513
CO
Other
Enumeration date
01/24/2024
Last updated
02/08/2024
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