Individual
CRYSTAL WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4108 E PARHAM RD STE 100, RICHMOND, VA 23228-2754
(804) 902-7565
(804) 994-0515
Mailing address
4108 E PARHAM RD STE 100, RICHMOND, VA 23228-2754
(804) 902-7565
(804) 994-0515
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904013546
VA
Other
Enumeration date
08/01/2022
Last updated
03/07/2023
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