| Doctor Name: | DR. ALBAN DAVID WALL |
| NPI Number: | 1578770087 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 3183 |
| Business Practice Address: | 1 E Apache St Wickenburg, AZ - 853902442 |
| Business Phone Number: | 9286844591 |
| Business Fax Number: | 9286844590 |
| Mailing Address: | 8807 W Williams Rd, PEORIA |
| State: | AZ |
| Postal Code: | 853831904 |
| Phone Number: | 6235726631 |
| Fax Number: | |
| NPI Enumeration Date: | 05/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 3183 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |