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Individual

ANGEL MALANA WALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2920 W BROAD ST STE 215, RICHMOND, VA 23230-5103
(804) 988-1150
Mailing address
906 LISSON CRES, RICHMOND, VA 23225-4242
(828) 337-8812

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
VA

Other

Enumeration date
11/22/2025
Last updated
11/22/2025
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