Individual
NANCY WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3037 NW 63RD ST, STE 104, OKLAHOMA CITY, OK 73116-3637
(405) 524-3278
(405) 364-5379
Mailing address
PO BOX 1729, NORMAN, OK 73070-1729
(405) 809-4222
(405) 364-5379
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
346
OK
Other
Enumeration date
09/22/2006
Last updated
05/09/2011
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