Individual
KATHLEEN WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
11165 SEPULVEDA BLVD, MISSION HILLS, CA 91345-1113
(818) 837-5779
(818) 837-5779
Mailing address
PO BOX 9602, MISSION HILLS, CA 91346-9602
(818) 837-5691
(818) 792-4793
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
815870
AR
Other
Enumeration date
10/20/2005
Last updated
04/03/2014
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