NPI | 1194194985 |
---|---|
Former Name | BETSY L WALLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: WI 128854-121) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 8374-123) |
Enumeration Date | 2015-09-22 |
Last Update Date | 2021-03-11 |