Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 50267 | TX |
NPI | 1003018540 |
---|---|
Provider Name | Amy C Waldner |
First Address | Houston, TX 77008-7062 |
Second Address | Houston, TX 77008-7062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 08/07/2007 |