Individual
MARIAH WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY. S., NCSP
Contact information
Practice address
158 STATE RD 531, BLDG B, TIERRA AMARILLA, NM 87575
(575) 588-7285
Mailing address
3415 BOQUILLAS CT, KATY, TX 77494-1391
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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