Katie Waller, LCDC
Counselor, Addiction (Substance Use Disorder) in Huntsville, TX. Individual provider (NPI-1).
NPI number1750816930
StatusActive
Last updated in NPPESApr 26, 2017
Details
- NPI
- 1750816930
- Entity type
- Individual (NPI-1)
- Name
- Katie Waller
- Credential
- LCDC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 26, 2017
- Last updated
- Apr 26, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 12081 | TX | Yes |
Practice location
1523 Normal Park DrSuite C
Huntsville, TX 77340-4297
Phone 855-862-3278
Mailing address
Po Box 474Angleton, TX 77516-0474
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