Gordon John Waller

NPI #1780121731 in Orem, Utah

Provider Information

NPI Number
1780121731
Entity Type
Individual
Name
Gordon John Waller
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Behavior Technician
Enumeration Date
Jan 30, 2017
Last Updated
Jan 12, 2021

Practice Location

Address
475 W 260 N
City
Orem
State
Utah
ZIP Code
84057-1970
Phone
(801) 221-9930

Specialties & Taxonomy Codes

Specialty
Counselor - Mental HealthMental Health
Behavior Technician

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