Dr. John R. Wallis
Pastoral Counselor
1417 Se 4th St
Ft Lauderdale
, Florida 33301-2319
Dr. John R. Wallis
Pastoral Counselor
1417 Se 4th St
Ft Lauderdale
, Florida 33301-2319
(954) 779-1643
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About
Features
Specialties
- Pastoral Counselor
Languages spoken
- English
Location
First Address
- Dr. John R. Wallis
- 1417 Se 4th St
- Ft Lauderdale, FL
- Zip : 33301-2319
- Fax : (954) 779-1643
- Phone : (954) 463-2273
Second Address
- Dr. John R. Wallis
- 1417 Se 4th St
- Ft Lauderdale, FL
- Zip : 33301-2319
- Fax : (954) 779-1643
- Phone : (954) 463-2273
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YP1600X | Pastoral Counselor | MT1251 | FL |
National Provider Identifier
| NPI | 1023161197 |
|---|---|
| Provider Name | Dr. John R. Wallis |
| First Address | Ft Lauderdale, FL 33301-2319 |
| Second Address | Ft Lauderdale, FL 33301-2319 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/01/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.