| NPI | 1720154834 |
|---|---|
| Former Name | ANNIE K WALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WA MA7355) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00007355) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2025-01-03 |