Individual
LELAND BERRY WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
12301 MAIN ST, HOUSTON, TX 77035-6207
(713) 275-5320
Mailing address
12301 MAIN ST, HOUSTON, TX 77035-6207
(713) 275-5320
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3948
TX
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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