Individual
KIMBERLY B WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
107 SUNNYBROOK RD, WAKE BROOK BUILDING, RALEIGH, NC 27610-1827
(919) 747-0507
(919) 747-0577
Mailing address
107 SUNNYBROOK RD, WAKE BROOK BUILDING, RALEIGH, NC 27610-1827
(919) 747-0507
(919) 747-0577
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7498
NC
Other
Enumeration date
10/27/2011
Last updated
10/27/2011
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