Wall, Nichelle M.
Wall, Nichelle M. is an individual health care provider with primary practice located at 1264 Harwood Rd 175, Bedford TX 76021-4267. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Wall, Nichelle M. can be contacted via phone (214) 396-6503.Contact Information
Primary practice address
1264 Harwood Rd 175
Bedford TX 76021-4267
Phone: (214) 396-6503
Fax: (469) 359-6729
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 69796 | Texas |
Profile Details
| NPI number | 1437569324 |
|---|---|
| LBN Legal business name | Wall, Nichelle M. |
| Credentials | M. ED., LPC, CST-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2014 |
| Last updated | Mar 16th, 2016 - about 10 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 | 1437569324 | NPPES |
| Texas | MEDICAID | 220346501 |
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