Individual
MS. MADISON WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5050 MADISON RD, CINCINNATI, OH 45227-1491
(513) 272-2800
(513) 272-2807
Mailing address
5050 MADISON RD, CINCINNATI, OH 45227-1491
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
123456-SUPV
OH
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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