Organization
MICHELLE L WALL, LLC
Active
Other names
ABC Case Management
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE WALL MHS, LRC (OWNER)
(225) 667-4014
Entity
Organization
Contact information
Practice address
1 LAKESHORE DR, SUITE 1620, LAKE CHARLES, LA 70629-0100
(337) 421-1510
(337) 421-1516
Mailing address
PO BOX 1284, DENHAM SPRINGS, LA 70727-1284
(225) 667-4014
(225) 667-4886
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
27071
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2194534
—
LA
Enumeration date
03/28/2016
Last updated
03/28/2016
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