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Individual
SAMANTHA DIANE WALLS
Active
Individual
SAMANTHA DIANE WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.022634
IL
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
11/23/2010
Last updated
10/13/2023
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