Individual
SAVANNAH MARIE WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1547 PARKWAY, GREENWOOD, SC 29646-4081
(864) 229-7120
Mailing address
1547 PARKWAY, GREENWOOD, SC 29646-4081
(864) 229-7120
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3335
MEDICARE
SC
05
—
421504
—
SC
Enumeration date
09/14/2020
Last updated
06/22/2021
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