Individual
MRS. TABATHA WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
420 GROVE ST, RICHWOOD, OH 43344-9022
(740) 943-1725
Mailing address
420 GROVE ST, RICHWOOD, OH 43344-9022
(740) 943-1725
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
MA1001111
OH
Other
Enumeration date
05/06/2015
Last updated
05/06/2015
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