Michelle Kathryn Wall
Michelle Kathryn Wall is a Developmental Therapist in Decatur, Illinois. Practices as a sole proprietor. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
1360 W Riverview AveDecatur, IL 62522-2722
Phone: (217) 853-5348
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Specialties & licences
| Developmental Therapist (primary) | Taxonomy 222Q00000X |
|---|
Record details
| NPI number | 1710635784 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | March 17, 2022 |
| Last updated in NPPES | March 17, 2022 |
| Certification date | March 17, 2022 |
| Mailing address | 1360 W Riverview Ave, Decatur, IL 62522-2722 |
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