| Doctor Name: | REGINA WALL |
| NPI Number: | 1053346502 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW LCSW BCD |
| License Number: | SC01436 |
| Business Practice Address: | 100 Straube Center Blvd Suite 203 Pennington, NJ - 085341447 |
| Business Phone Number: | 6092989144 |
| Business Fax Number: | 6092989288 |
| Mailing Address: | 103 Point Ct, LAWRENCEVILLE |
| State: | NJ |
| Postal Code: | 086482861 |
| Phone Number: | 6094341418 |
| Fax Number: | |
| NPI Enumeration Date: | 07/12/2006 |
| NPI Last Update Date: | 04/30/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SC01436 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |