| NPI | 1710753835 |
|---|---|
| Other Name | LANAY DENIECE WALLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 149.026493) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 21114) |
| 1041C0700X Social Worker, Clinical (Licence: IL 149.026493) | |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2024-08-19 |