Individual
DR. KODEE WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
600 N EAGLESON AVE, BLOOMINGTON, IN 47405-3190
(812) 855-5711
Mailing address
1209 E CHESTNUT CT, BLOOMINGTON, IN 47401-6650
(785) 209-2914
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
2547
KS
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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