Provider Demographics
NPI:1194508739
Name:WAYMAN, ALLIE (FNTP, RWP)
Entity type:Individual
Prefix:
First Name:ALLIE
Middle Name:
Last Name:WAYMAN
Suffix:
Gender:F
Credentials:FNTP, RWP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 GOLDEN GROVE DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-6118
Mailing Address - Country:US
Mailing Address - Phone:214-766-1342
Mailing Address - Fax:
Practice Address - Street 1:923 GOLDEN GROVE DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-6118
Practice Address - Country:US
Practice Address - Phone:214-766-1342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach