Wall, Deborah A
Wall, Deborah A is an individual health care provider with primary practice located at 107 Cranes Roost Ct , Elizabethtown KY 42701-3650. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Wall, Deborah A can be contacted via phone (270) 765-2605.Contact Information
Primary practice address
107 Cranes Roost Ct
Elizabethtown KY 42701-3650
Phone: (270) 765-2605
Fax: (270) 234-8572
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X |
Profile Details
| NPI number | 1629111968 |
|---|---|
| LBN Legal business name | Wall, Deborah A |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629111968 | NPPES |
| Kentucky | MEDICAID | 30605018 |
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