Individual
DEBORAH WALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
546 THIRD ST, MASON, WV 25260
(407) 687-9860
Mailing address
PO BOX 198, MASON, WV 25260-0198
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/10/2021
Last updated
03/10/2021
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