| Lynda S. Walls, Ph.d., Inc. | |
|
931 Cassat Ave Jacksonville FL 32205-4857 | |
| (904) 388-2828 | |
| Not Available |
| Full Name | Lynda S. Walls, Ph.d., Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 931 Cassat Ave, Jacksonville, Florida |
| Authorized Official Name and Position | Lynda Smith Walls (OWNER) |
| Authorized Official Contact | 9045368095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lynda S. Walls, Ph.d., Inc. 13018 Viburnum Dr N Jacksonville FL 32246-1144 Ph: (904) 536-8095 | Lynda S. Walls, Ph.d., Inc. 931 Cassat Ave Jacksonville FL 32205-4857 Ph: (904) 388-2828 |
| NPI Number | 1245598499 |
|---|---|
| Provider Enumeration Date | 04/25/2012 |
| Last Update Date | 04/25/2012 |
| Medicare PECOS PAC ID | 5890957559 |
|---|---|
| Medicare Enrollment ID | O20120426000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245598499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 4887 (Florida) | Primary |
| Provider Name | Lynda S Walls |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1184722217 PECOS PAC ID: 6204739329 Enrollment ID: I20040128000185 |
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