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Organization

DENISE C. WALL, LCSW LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DENISE CECILIA WALL LCSW (PSYCHO THERAPIST)
(302) 376-5259
Entity
Organization

Contact information

Practice address
610 MAIN ST, ODESSA, DE 19730-2012
(302) 376-5259
(302) 689-4474
Mailing address
PO BOX 514, ODESSA, DE 19730-0514
(302) 376-5259
(302) 689-4474

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
Q1-0000304
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000032277
DE
01
1041C0700X
TAXONOMY
DE
01
1093814972
NPI TYPE I
DE
Enumeration date
03/19/2013
Last updated
03/19/2013
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