# DR. LA'TONYA RENAE WALLS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1033386008
- **Gender:** F
- **Credential:** PHD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041S0200X | School Social Worker | 625048 | WI | Yes |
| 106H00000X | Marriage & Family Therapist | 91-228 | WI | — |

## Other

- **Enumeration date:** 05/09/2008
- **Last updated:** 05/09/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 40950400 | — | WI |