Male or Other

Christian Waller

Mental Health Counselor in Augusta, GA(View on Map)

Full Name

Christian Waller

NPI Number

1750033510

NPI Type

Individual Provider

Gender

Male

Enumeration Date

01/24/2022

Specialties

(Taxonomies)

Code

101YM0800X

Primary Taxonomy

Yes

Licenses

State

Georgia

License Number

LPC012689

Contact
Information

Purpose

Mailing
Location

Address

2761 ROCKY CREEK RD
2761 ROCKY CREEK RD

City

Augusta
Augusta

State

GA
GA

Postal Code

30906-2657
30906-2657

Country

US
US

Telephone Number

(678) 258-5400
(678) 258-5400

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 01/24/2022

Provider Address

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