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General NPI Number Information
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NPI Number | 1700944907
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Entity Type | Individual
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Provider Name | SALLEY A WALLIN LCSW, MSW
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Gender | Female
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 10547 E SEVEN GENERATIONS WAY # 201-11
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City | TUCSON
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State | AZ
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Zip | 85747
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Country | US
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Telephone | 520-282-1794
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Fax | 520-296-7579
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Provider Business Mailing Address
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Address Line | PO BOX 17952
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City | TUCSON
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State | AZ
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Zip | 85731-7952
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Country | US
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Telephone | 520-282-1794
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Fax | 520-296-7579
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW 2434
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License Number State | AZ
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