Individual
JECHELL LARY-WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
452 GRAHAM WOODS CIR, GRAY, GA 31032-4914
(478) 390-3836
Mailing address
452 GRAHAM WOODS CIR, GRAY, GA 31032-4914
(478) 390-3836
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN15699
GA
Other
Enumeration date
01/31/2025
Last updated
07/24/2025
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