Individual
WILFRED WALLANG EBUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1905 ARAPAHOE CT, GREENWOOD, MO 64034-8636
(816) 419-1294
Mailing address
1905 ARAPAHOE CT, GREENWOOD, MO 64034-8636
(816) 419-1294
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
07/23/2012
Last updated
07/23/2012
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