Individual
KATIE WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
1523 NORMAL PARK DR, SUITE C, HUNTSVILLE, TX 77340-4297
(855) 862-3278
Mailing address
PO BOX 474, ANGLETON, TX 77516-0474
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12081
TX
Other
Enumeration date
04/26/2017
Last updated
04/26/2017
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