AUTUMN WALL

LAFAYETTE, IN
NPI1871986661
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IN  34007785A)
Additional Taxonomies1041C0700X Social Worker, Clinical
(Licence: IL  149.017038)
Enumeration Date2015-03-18
Last Update Date2023-09-27
Business Address
AUTUMN WALL LCSW
1116 N 16TH ST
LAFAYETTE, IN 47904-2119
Phone number: 765-423-6300
Mailing Address
AUTUMN WALL LCSW
PO BOX 781076
DETROIT, MI 48278-1076
Phone number: 317-528-4800