Individual
DR. LORI L WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
319 S 14TH ST STE 3, SEWARD, NE 68434
(402) 435-3353
(402) 643-2315
Mailing address
319 S 14TH ST STE 3, SEWARD, NE 68434-2320
(402) 435-3353
(402) 643-2315
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
460
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-083295526
—
NE
Enumeration date
07/04/2006
Last updated
05/26/2018
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