IndividualActive
Amy Wallis, LPC
NPI 1780930370 · Mental Health Counselor · Moore, OK
Provider details
- NPI number
- 1780930370
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- Yes
- License
- 6156 (OK)
Mailing address
620 Nw 5th St Ste D
Moore, OK 73160-3947
Registry dates
- Enumerated
- 2012-08-01
- Last updated
- 2023-02-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.