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General NPI Number Information
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NPI Number | 1750513479
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Entity Type | Individual
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Provider Name | LISA ALINE LOVGREN WALLS P-LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/13/2009
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Last Update Date | 08/13/2009
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Provider Practice Location Address
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Address Line | 516 W INNES ST STE 6
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City | SALISBURY
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State | NC
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Zip | 28144-4276
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Country | US
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Telephone | 704-756-6877
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Fax |
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Provider Business Mailing Address
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Address Line | 7324 LAWYERS STATION RD
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City | MINT HILL
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State | NC
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Zip | 28227-1403
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Country | US
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Telephone | 704-400-8628
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | P005076
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License Number State | NC
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