Individual
TAMIKA Y WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 THOMPSON RD, WEBSTER, MA 01570-1509
(508) 640-2991
(508) 943-2605
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
RN230540
MA
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
230540
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110122379A
—
MA
Enumeration date
09/26/2006
Last updated
02/11/2026
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