Individual provider · Type 1 NPI
John Robert Wallis, L.P.C.
Mental Health Counselor · Wasilla, AK
NPI number
1851545396
Active
Practice location
3901 E Bogard Rd
Wasilla, AK 99654-6068
Fax (907) 376-0493
Mailing address
1825 S Chugach St
Palmer, AK 99645-6795
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | AA450 (AK) |
Mental Health Counselor: Definition to come...
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About NPI 1851545396
John Robert Wallis, L.P.C.'s National Provider Identifier is 1851545396, issued on Nov 11, 2008. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Wasilla, AK. The record was last updated on Nov 11, 2008.