Wall, Judith V
Wall, Judith V is an sole proprietor health care provider with primary practice located at 759 Sw Federal Hwy #203, Stuart FL 34994-2914. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wall, Judith V can be contacted via phone (772) 219-0779.Contact Information
Primary practice address
759 Sw Federal Hwy #203
Stuart FL 34994-2914
Phone: (772) 219-0779
Fax: (772) 221-7885
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW3067 | Florida |
Profile Details
| NPI number | 1619029683 |
|---|---|
| LBN Legal business name | Wall, Judith V |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 18th, 2007 |
| Last updated | Jul 6th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619029683 | NPPES |
| Florida | MEDICAID | 211492500 | |
| Florida | Other | 088978 | |
| Florida | Other | 112262000 |
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