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Walter Wallace
NPI 1346008166 · on the registry since 2024 · sole proprietor
Practice
- Address
- 415 N Richard Jackson Blvd Ste 206b
Panama City, FL 32407 - Phone
- (352) 871-2425
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- Social Worker
104100000X
- Licence states on file
- FL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-03-07
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida