Amanda Wallace, PSY.D

NPI 1972908010 · on the registry since 2014

Practice

Address: 1500 N Westwood Blvd
Poplar Bluff, MO 63901
Phone: (573) 778-4122
Organisation at this address: St. Louis Jc Vamc
St. Louis Jc Vamc
John J. Pershing Vamc
Department Of Veterans Affairs
John J Pershing Va Medical Center
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 194

Registry record

Primary taxonomy: 103TC0700X
103TC0700X
Also registered as: 103TF0200X
Licence states on file: MO
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2014-10-31

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri