Individual
BRYANT WILLIS WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
22 RUTLEDGE RD, NATICK, MA 01760-1729
(508) 647-6400
Mailing address
30 MERRIAM WAY, UPTON, MA 01568-1675
(508) 647-6400
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
114169-SW-LICSW
MA
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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