DR. Amanda Jo Wallace, PSY.D.
NPI #1972908010 in Poplar Bluff, Missouri
Provider Information
- NPI Number
- 1972908010
- Entity Type
- Individual
- Name
- DR. Amanda Jo Wallace, PSY.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Psychologist - Clinical
- Credential
- PSY.D.
- Enumeration Date
- Oct 31, 2014
- Last Updated
- Oct 31, 2014
Practice Location
- Address
- 1500 N WESTWOOD BLVD
- City
- Poplar Bluff
- State
- Missouri
- ZIP Code
- 63901-3318
- Phone
- (573) 778-4122
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
| Psychologist - Forensic — Forensic |
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