Gordon John Waller
Gordon John Waller is a Mental Health Counselor in Orem, Utah. Practices as a sole proprietor and works from 2 locations. Registered with an NPI since 2017.
- In the registry since
- 2017
- Specialties on file
- 2
Practice location Address checks out
475 W 260 NOrem, UT 84057-1970
Phone: (801) 221-9930
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 8915 Sw Center St, Tigard, OR 97223-6307 — (602) 785-8595
Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X |
|---|---|
| Mental Health Counselor | Taxonomy 101YM0800X |
Record details
| NPI number | 1780121731 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | January 30, 2017 |
| Last updated in NPPES | January 12, 2021 |
| Certification date | January 12, 2021 |
| Mailing address | 475 W 260 N, Orem, UT 84057-1970 |
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