Denise C. Wall, Lcsw Llc | |
610 Main St Odessa DE 19730-2012 | |
(302) 376-5259 | |
(302) 689-4474 |
Full Name | Denise C. Wall, Lcsw Llc |
---|---|
Speciality | Social Worker - Clinical |
Location | 610 Main St, Odessa, Delaware |
Authorized Official Name and Position | Denise Cecilia Wall (PSYCHO THERAPIST) |
Authorized Official Contact | 3023765259 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Denise C. Wall, Lcsw Llc Po Box 514 Odessa DE 19730-0514 Ph: (302) 376-5259 | Denise C. Wall, Lcsw Llc 610 Main St Odessa DE 19730-2012 Ph: (302) 376-5259 |
NPI Number | 1063754877 |
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Provider Enumeration Date | 03/19/2013 |
Last Update Date | 03/19/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063754877 | NPI | - | NPPES |
1041C0700X | Other | DE | TAXONOMY |
1000032277 | Medicaid | DE | |
1093814972 | Other | DE | NPI TYPE I |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | Q1-0000304 (Delaware) | Primary |