IndividualActive
Amanda Wallace, PSY.D.
NPI 1972908010 · Clinical Psychologist · Poplar Bluff, MO
Provider details
- NPI number
- 1972908010
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PSY.D.
- Sex
- Female
- Sole proprietor
- No
- License
- 2009031094 (MO)
Practice location
1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318
Phone: (573) 778-4122
Mailing address
1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318
Registry dates
- Enumerated
- 2014-10-31
- Last updated
- 2014-10-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.