Individual
MS. SUSAN DALE WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
77 W FOREST AVE, SUITE 202, FLAGSTAFF, AZ 86001-1479
(928) 773-2249
(928) 214-3981
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW - 2625
AZ
Other
Enumeration date
02/07/2017
Last updated
03/01/2017
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