Most Relevant Information
Provider Data
| NPI Number: | 1003313172 |
| Provider Name: | PAUL TIMOTHY WALDROOP LPC,LICDC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | LICDC.162520 |
Most Important Dates
| Enumeration Date: | 04/06/2018 |
| Last Updated: | 12/28/2023 |
Provider Practice Location
705 S BROWN SCHOOL RD
VANDALIA
OH
453773113
Practice Location Phone/Fax
| Phone: | 9378905400 |
| Fax: | 9378905401 |
Provider Mailing Location
705 S BROWN SCHOOL RD
VANDALIA
OH
453773113
Provider Mailing Phone/Fax
| Phone: | 9378905400 |
| Fax: | 9378905401 |