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Individual
ALICIA WALL
Active
Individual
ALICIA WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1229-039
WI
225X00000X
Occupational Therapist
Primary
5527-26
WI
Other
Enumeration date
02/11/2011
Last updated
08/06/2026
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