Grayson Wallen, LPCC
Counselor, Professional in Encinitas, CA. Individual provider (NPI-1).
NPI number1962007369
StatusActive
Last updated in NPPESAug 17, 2022
Details
- NPI
- 1962007369
- Entity type
- Individual (NPI-1)
- Name
- Grayson Wallen
- Credential
- LPCC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 2, 2020
- Certification date
- Aug 17, 2022
- Last updated
- Aug 17, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 5227 | CA | Yes |
Practice location
169 Saxony Rd Ste 205Encinitas, CA 92024-6780
Phone 480-234-8363
Mailing address
169 Saxony Rd Ste 205Encinitas, CA 92024-6780
Phone 480-234-8363
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