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:
Health care specialties
| Specialty | Code | License # | 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 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 | 1730115536 | NPPES |
| Pennsylvania | Other | 7073245 | AETNA |
| Pennsylvania | Other | 2139104000 | AETNA |
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