Individual provider · Type 1 NPI

Michelle Kathryn Wall

Developmental Therapist · Decatur, IL

NPI number 1710635784 Active

Practice location

1360 W Riverview Ave
Decatur, IL 62522-2722

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1710635784

Michelle Kathryn Wall's National Provider Identifier is 1710635784, issued on Mar 17, 2022. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Decatur, IL. The record was last updated on Mar 17, 2022.