Individual
JASON E WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
2108 E ASHWOOD LN, BLOOMINGTON, IN 47401-9769
(785) 209-2977
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39004636A
IN
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
08/05/2013
Last updated
02/24/2025
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