Individual provider · Type 1 NPI

Amanda Jo Wallace, PSY.D.

Clinical Psychologist · Poplar Bluff, MO

NPI number 1972908010 Active

Practice location

1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318

Call (573) 778-4122 Map

Specialties and licenses

TaxonomyCodeLicense
Clinical Psychologist Primary 103TC0700X2009031094 (MO)
Forensic Psychologist 103TF0200X2009031094 (MO)

Clinical Psychologist: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of discip…

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About NPI 1972908010

Amanda Jo Wallace, PSY.D.'s National Provider Identifier is 1972908010, issued on Oct 31, 2014. The primary taxonomy on file is Clinical Psychologist (103TC0700X), and the practice location is in Poplar Bluff, MO. The record was last updated on Oct 31, 2014.