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Individual

DONNA WALLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN QMHP

Contact information

Practice address
208 LINCOLN WAY, DIXON, IL 61021-2019
(815) 973-2404
Mailing address
208 LINCOLN WAY, DIXON, IL 61021-2019
(815) 973-2404

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
041.310106
IL

Other

Enumeration date
07/10/2015
Last updated
07/10/2015
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