Individual
MRS. DENISE M WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN, IBCLC, RLC
Contact information
Practice address
519 CROSS CREEK WAY, PALMYRA, VA 22963-4904
(434) 962-7414
Mailing address
519 CROSS CREEK WAY, PALMYRA, VA 22963-4904
(434) 962-7414
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11010140
VA
Other
Enumeration date
03/09/2012
Last updated
03/09/2012
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