Individual
TERRY L WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
45 E LOUCKS ST, SUITE 301, SHERIDAN, WY 82801-6339
(307) 751-1406
Mailing address
1100 US HIGHWAY 14, BANNER, WY 82832-9711
(307) 751-1406
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT-078
WY
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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