Individual
DR. ALEXIS G WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, MDIV, THD, LCPCC
Contact information
Practice address
6 FEDERAL ST STE F, BRUNSWICK, ME 04011-1508
(207) 200-3115
Mailing address
6 FEDERAL ST STE F, BRUNSWICK, ME 04011-1508
(757) 406-1831
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
XL7023
ME
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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