Provider Demographics
NPI:1649491572
Name:WALLING, CURTIS CRAIG (PHD)
Entity type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:CRAIG
Last Name:WALLING
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4222 E CAMELBACK RD STE 230H
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2787
Mailing Address - Country:US
Mailing Address - Phone:602-625-7889
Mailing Address - Fax:480-704-5550
Practice Address - Street 1:4222 E CAMELBACK RD STE 230H
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2787
Practice Address - Country:US
Practice Address - Phone:602-625-7889
Practice Address - Fax:480-704-5550
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1343103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical