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Individual

TASHA WALLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LGSW

Contact information

Practice address
5130 DORSEY HALL DR, ELLICOTT CITY, MD 21042-7870
(301) 609-9887
Mailing address
PO BOX 2924, LA PLATA, MD 20646-2984
(301) 609-9887
(301) 609-9091

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MD

Other

Enumeration date
12/20/2017
Last updated
12/20/2017
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