Individual
TAMMY SUE WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-5311
(208) 625-4184
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-5311
(208) 625-4184
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW34849
ID
Other
Enumeration date
04/22/2021
Last updated
07/25/2025
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