Individual
ANDREW ROGER WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
200 FARADAY PLZ, WINCHESTER, VA 22603-4669
(833) 510-4357
(866) 460-2997
Mailing address
615 ELSINORE PL, CINCINNATI, OH 45202-1459
(833) 510-4357
(866) 460-2997
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
0704013133
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0701011585
VA
Other
Enumeration date
06/07/2022
Last updated
07/19/2022
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