Individual
DR. WILLIAM WALLACE WARDELL
Active
Individual
DR. WILLIAM WALLACE WARDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
23489
TX
103TC0700X
Clinical Psychologist
Primary
23489
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034153901
—
TX
05
—
034153902
—
TX
01
—
P00930109
RR MCR
TX
Enumeration date
07/24/2006
Last updated
10/21/2011
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