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Individual

MRS. DANIELLE LYNN WALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
31 NORTH MAIN ST, TOMS RIVER, NJ 08753
(908) 216-5825
Mailing address
17 TULIP LANE, FREEHOLD, NJ 07728
(609) 216-5825

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05332900
NJ

Other

Enumeration date
10/20/2011
Last updated
10/20/2011
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