Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Amanda Jo Wallace, PSYD

Individual provider Clinical Psychologist · NPI 1972908010

Dr. Amanda Jo Wallace, PSYD is a Clinical Psychologist in Poplar Bluff, Missouri. Licensed in Missouri. Registered with an NPI since 2014.

Licensed in
MO
In the registry since
2014
Specialties on file
2
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318
Phone: (573) 778-4122
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 2009031094 (MO)
Forensic Psychologist Taxonomy 103TF0200X · Licence 2009031094 (MO)

Record details

NPI number1972908010
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorNo
NPI enumeratedOctober 31, 2014
Last updated in NPPESOctober 31, 2014
Mailing address1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318

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