NPI 1033656939

Jacqueline Thomas Walls

Practitioner Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Demopolis, AL

Practice location

Address: 803 Floyd Ave, Demopolis, AL 36732-3157
Phone: (334) 349-6916

Registered specialties (2)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

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Registered Nurse

Nursing Service Providers Taxonomy 163W00000X Licence 1-080172 (AL)

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Registry record

NPI: 1033656939
Entity type: Individual
Sex (as registered): Female
NPI issued: 30 Jan 2017
Record last updated: 30 Jan 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.