Wall, Stehanie D

Wall, Stehanie D is an sole proprietor health care provider with primary practice located at 1357 Wayside Rd , Raeford NC 28376-6513. She recently has 3 registered licenses in different health care specialties including Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, Other Service Providers / Case Manager/Care Coordinator, Transportation Services / Private Vehicle. Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness is her primary health care specialty. Wall, Stehanie D can be contacted via phone (910) 565-2139.

Contact Information

Primary practice address
1357 Wayside Rd Raeford NC 28376-6513
Phone: (910) 565-2139
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X MHL-047-152 North Carolina
Other Service Providers / Case Manager/Care Coordinator 171M00000X 27-0962043 South Carolina
Transportation Services / Private Vehicle 347C00000X 27-0962043 South Carolina

Profile Details

NPI number 1083045306
LBN Legal business name Wall, Stehanie D
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 12th, 2013
Last updated Jan 9th, 2015 - about 9 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 1083045306 NPPES
South Carolina MEDICAID 1083045306
South Carolina Other 1083045306

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