NPI 1063552586

Michael Patrick Wall, LCSWC

Practitioner Clinical Social Worker Severna Park, MD

Practice location

Address: 692 Ritchie Hwy Suite 203, Severna Park, MD 21146-3919
Phone: (410) 647-4862
Mailing address: 64 Dungarrie Rd, Balto, MD 21228-3401

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence LCSWC07449 (MD)

Other Social Worker providers in Maryland →

Registry record

NPI: 1063552586
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Feb 2007
Record last updated: 8 Jul 2007

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.