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1467208918
TARA WALLER
ROANOKE, VA
NPI
1467208918
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: VA 0904016744)
Enumeration Date
2024-04-25
Last Update Date
2024-04-25
Business Address
TARA WALLER
1454 MEXICO WAY NE
ROANOKE, VA 24012-6476
Phone number: 434-533-1088
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Mailing Address
TARA WALLER
724 SHELBOURNE AVE
VINTON, VA 24179-3720
Phone number: 304-747-8587
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