Individual
MRS. JODI WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMHC
Contact information
Practice address
911 SW 29TH TER, CAPE CORAL, FL 33914-4297
(239) 272-3027
Mailing address
911 SW 29TH TER, CAPE CORAL, FL 33914-4297
(239) 272-3027
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH 9376
FL
171M00000X
Case Manager/Care Coordinator
Primary
9376
FL
171W00000X
Contractor
9736
FL
Other
Enumeration date
04/21/2009
Last updated
04/12/2022
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