Wall, Maryann

Wall, Maryann is an individual health care provider with primary practice located at 7340 Jackson St , Philadelphia PA 19136-4008. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wall, Maryann can be contacted via phone (215) 624-5691.

Contact Information

Primary practice address
7340 Jackson St Philadelphia PA 19136-4008
Phone: (215) 624-5691
Fax: (215) 624-5816
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X CW013986 Pennsylvania

Profile Details

NPI number 1730115536
LBN Legal business name Wall, Maryann
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Feb 4th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730115536 NPPES
Pennsylvania Other 7073245 AETNA
Pennsylvania Other 2139104000 AETNA

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