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Individual

DR. MATTHEW WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
1573 W FAIRBANKS AVE STE 220, WINTER PARK, FL 32789-4679
(407) 303-7991
Mailing address
1573 W FAIRBANKS AVE STE 220, WINTER PARK, FL 32789-4679

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary

Other

Enumeration date
10/10/2022
Last updated
09/05/2025
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