Individual
MS. DOROTHY WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
402 22ND AVE N, NASHVILLE, TN 37203-1949
(615) 251-8805
Mailing address
402 22ND AVE N, NASHVILLE, TN 37203-1949
(615) 251-8805
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
43-2001774
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H445756
—
TN
Enumeration date
04/11/2016
Last updated
04/11/2016
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