Individual
MS. CAROL LYNN GATES WALLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, , COMS
Contact information
Practice address
1109 PLYMOUTH DR APT B, CHAMPAIGN, IL 61821-6567
(717) 420-0145
Mailing address
1109 PLYMOUTH DR APT B, CHAMPAIGN, IL 61821-6567
(717) 420-0145
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
857266
IL
Other
Enumeration date
08/02/2010
Last updated
08/02/2010
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