Wall, Debra L

Wall, Debra L is an individual health care provider with primary practice located at 1504 Harcrest Dr Suite 3, Midland MI 48640-4717. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Wall, Debra L can be contacted via phone (989) 835-1219.

Contact Information

Primary practice address
1504 Harcrest Dr Suite 3 Midland MI 48640-4717
Fax: (989) 835-7198
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X Michigan

Profile Details

NPI number 1750485371
LBN Legal business name Wall, Debra L
Credentials AUD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 12th, 2006
Last updated Apr 18th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750485371 NPPES
Michigan Other 540E610370 BCBSM
Michigan MEDICAID 904508130 BCBSM

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