Individual
TACHISHA MAE WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 E CHESTNUT ST UNIT 610, LOUISVILLE, KY 40202-5711
(502) 588-4450
(502) 588-9539
Mailing address
401 E CHESTNUT ST UNIT 610, LOUISVILLE, KY 40202-5711
(502) 588-4450
(502) 588-9539
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3016808
KY
Other
Enumeration date
10/16/2021
Last updated
12/13/2021
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