Individual
DR. TERRI NORTHUP WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
13500 SUTTON PARK DR S, SUITE 203, JACKSONVILLE, FL 32224-5251
(904) 992-9930
(904) 992-9937
Mailing address
13500 SUTTON PARK DR S, SUITE 203, JACKSONVILLE, FL 32224-5251
(904) 992-9930
(904) 992-9937
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 6112
FL
Other
Enumeration date
01/15/2008
Last updated
01/15/2008
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