Dr Joseph Wallach PHD LLC

NPI #1336415611 in Evanston, Illinois

Provider Information

NPI Number: 1336415611
Entity Type: Organization
Organization Name: Dr Joseph Wallach PHD LLC
Primary Specialty: Psychologist - Clinical
Enumeration Date: Mar 30, 2012
Last Updated: Mar 30, 2012

Practice Location

Address: 2530 CRAWFORD AVE
Address 2: SUITE 304
City: Evanston
State: Illinois
ZIP Code: 60201-4970
Phone: (773) 852-2400

Authorized Official

Name: DR. JOSEPH WALLACH, PH.D.
Title: LICENSED CLINICAL PSYCHOLOGIST
Phone: (773) 852-2400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Cognitive & Behavioral — Cognitive & Behavioral	103TB0200X
Psychologist - Health — Health	103TH0004X
Psychologist - Clinical — Clinical	103TC0700X	Primary

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