Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ROGER A WALLACE, MA
Active Sole ProprietorROGER A WALLACE, MA is a Psychologist healthcare provider located in ARDEN, North Carolina. NPI 1053501783 is currently active in the NPPES registry. Verify at CMS.
Psychologist · ARDEN, NC
Registration Details
- NPI Number
- 1053501783
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 30, 2007 (19.046882281759 yrs)
- Last Updated
- Oct 16, 2008
- License
-
1179 (NC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
410 MILLS GAP RD.ARDEN, NC, 28704Browse NC providers · Browse ZIP 28704
- Phone
- 8286540111
- Fax
- 8286540111
- Primary Specialty
-
Psychologist
103T00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.