| Dr Wall & Associates, Llc | |
|
2825 S Meridian Rd Ste 150 Meridian ID 83642-7960 | |
| (208) 412-5128 | |
| (208) 955-2490 |
| Full Name | Dr Wall & Associates, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2825 S Meridian Rd Ste 150, Meridian, Idaho |
| Authorized Official Name and Position | Misty Lynn Wall (OWNER) |
| Authorized Official Contact | 2082979495 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Wall & Associates, Llc 2825 S Meridian Rd Ste 150 Meridian ID 83642-7960 Ph: (208) 412-5128 | Dr Wall & Associates, Llc 2825 S Meridian Rd Ste 150 Meridian ID 83642-7960 Ph: (208) 412-5128 |
| NPI Number | 1154952901 |
|---|---|
| Provider Enumeration Date | 01/30/2020 |
| Last Update Date | 01/30/2020 |
| Certification Date | 01/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154952901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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