SearchMississippi246ZS0400X

William Waller, CCP

NPI 1417801002 · on the registry since 2026 · sole proprietor

Practice

Address
314 Southwind Dr
Richland, MS 39218
Phone
(601) 502-4381

Registry record

Primary taxonomy
246ZS0400X
246ZS0400X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-02-23

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 Mississippi