Individual
GARRY WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
808 B ST, SAINT ALBANS, WV 25177-2727
(734) 250-1273
Mailing address
503 MOUNTAIN DR, SAINT ALBANS, WV 25177-8736
(734) 250-1273
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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