Doctor Name: | DR. MARK WALL |
NPI Number: | 1265617484 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | LPA-4347 |
Business Practice Address: | 5030 Maple Springs Blvd Dallas, TX - 752358321 |
Business Phone Number: | 2145221531 |
Business Fax Number: | |
Mailing Address: | 5030 Maple Springs Blvd, DALLAS |
State: | TX |
Postal Code: | 752358321 |
Phone Number: | 2145221531 |
Fax Number: | |
NPI Enumeration Date: | 01/07/2008 |
NPI Last Update Date: | 01/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LPA-4347 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |