| NPI | 1417251406 |
|---|---|
| Former Name | CAROLINE C WALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC12038) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2022-01-26 |