Organization
DR WALL & ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY LYNN WALL PHD, LCSW (OWNER)
(208) 297-9495
Entity
Organization
Contact information
Practice address
2825 S MERIDIAN RD STE 150, MERIDIAN, ID 83642-7960
(208) 412-5128
(208) 955-2490
Mailing address
2825 S MERIDIAN RD STE 150, MERIDIAN, ID 83642-7960
(208) 412-5128
(208) 955-2490
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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