Individual
TIFFANY R WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5501 DELMAR BLVD STE B300, SAINT LOUIS, MO 63112-3078
(314) 897-0289
Mailing address
5501 DELMAR BLVD STE B300, SAINT LOUIS, MO 63112-3078
(314) 897-0289
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/16/2010
Last updated
03/05/2024
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