NPI 1417773276

Larra Wall

Practitioner Emotionally Disturbed Childrens' Residential Treatment Facility Toledo, OH

Practice location

Address: 1820 Berdan Ave, Toledo, OH 43613-4612
Phone: (419) 908-2320

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

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Registry record

NPI: 1417773276
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Nov 2024
Record last updated: 26 Nov 2024

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.