Individual
HENRIETTA WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1430 S HIGH ST, COLUMBUS, OH 43207-1045
(614) 643-6822
Mailing address
1430 S HIGH ST, COLUMBUS, OH 43207-1045
(614) 643-6822
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
RN.437322
OH
Other
Enumeration date
07/02/2018
Last updated
06/07/2021
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