Individual
LISA MICHELLE WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
215 E 13TH AVE, CORDELE, GA 31015-4249
(229) 276-0100
(229) 276-0300
Mailing address
215 E 13TH AVE, CORDELE, GA 31015-4249
(229) 276-0100
(229) 276-0300
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005058
GA
Other
Enumeration date
01/13/2017
Last updated
01/10/2023
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