Individual
CHRISTIAN WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2761 ROCKY CREEK RD, AUGUSTA, GA 30906-2657
(678) 258-5400
Mailing address
2761 ROCKY CREEK RD, AUGUSTA, GA 30906-2657
(678) 258-5400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC012689
GA
Other
Enumeration date
01/24/2022
Last updated
01/24/2022
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