Individual
EMILY JO WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
2706 N CHURCH ST, GREENSBORO, NC 27405-3657
(336) 272-9990
Mailing address
420A CORONA ST, WINSTON SALEM, NC 27103-2817
(740) 602-1959
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/11/2020
Last updated
10/08/2020
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