Individual
DR. DEBRA L WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1504 HARCREST DR, SUITE 3, MIDLAND, MI 48640-4717
(989) 835-1219
(989) 835-7198
Mailing address
1504 HARCREST DR, SUITE 3, MIDLAND, MI 48640
(989) 835-1219
(989) 835-7198
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540E610370
BCBSM
MI
05
—
904508130
—
MI
Enumeration date
09/12/2006
Last updated
04/18/2012
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