Individual
GRAYSON WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
169 SAXONY RD STE 205, ENCINITAS, CA 92024-6780
(480) 234-8363
Mailing address
169 SAXONY RD STE 205, ENCINITAS, CA 92024-6780
(480) 234-8363
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5227
CA
Other
Enumeration date
12/02/2020
Last updated
08/17/2022
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