Doctor Name: | PEARLA DUNCAN WALL |
NPI Number: | 1013088335 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 000425 |
Business Practice Address: | 2784 N Decatur Rd Ste 145 Decatur, GA - 300335903 |
Business Phone Number: | 4042922664 |
Business Fax Number: | 4042922835 |
Mailing Address: | 1105 Whitehawk Trl, LAWRENCEVILLE |
State: | GA |
Postal Code: | 300437162 |
Phone Number: | 7702779122 |
Fax Number: | 7702779122 |
NPI Enumeration Date: | 11/10/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 000425 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |