| NPI | 1962560995 |
|---|---|
| Former Name | COURTNEY L WALLIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: AR 284) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: TN 1918) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2023-03-06 |