Individual provider · Type 1 NPI
Evelyn Waller
Mental Health Counselor · Philadelphia, PA
NPI number
1104200401
Active
Practice location
123 E Mayland St
Philadelphia, PA 19144-2020
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1104200401
Evelyn Waller's National Provider Identifier is 1104200401, issued on Jul 16, 2015. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Philadelphia, PA. The record was last updated on Jul 16, 2015.