Individual
MR. NATHANIEL ROSS WALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5610 READ BLVD, NEW ORLEANS, LA 70127-3106
(504) 241-8188
Mailing address
107 CENTRAL AVE, JEFFERSON, LA 70121-3401
(504) 214-7870
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
15271
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/04/2019
Last updated
05/25/2023
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