Individual
ELLEN WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
417 S JOHNSON ST, NEW ORLEANS, LA 70112-2237
(972) 391-4445
Mailing address
417 S JOHNSON ST, NEW ORLEANS, LA 70112-2237
(972) 391-4445
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6184
LA
Other
Enumeration date
05/09/2016
Last updated
05/10/2016
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