Individual
ELIZABETH PAMELA WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
660 PINE ST, MANCHESTER, NH 03104-3101
(978) 339-3256
Mailing address
660 PINE ST, MANCHESTER, NH 03104-3101
(978) 339-3256
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
01/03/2012
Last updated
03/08/2017
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