Individual
DR. LOISE KING WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1306 W LYNN ST RM 8, AUSTIN, TX 78703-3956
(512) 469-9447
Mailing address
4330 BULL CREEK RD APT 2416, AUSTIN, TX 78731-5954
(512) 797-4544
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
38226
TX
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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