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NPI Code Detail

MEDICARE: MORGAN WALL

MEDICARE: MORGAN WALL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1205540580
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN WALL
Provider Business Mailing Address
First Line : 38 BROWN HOLLOW LN
Second Line :
City : WAVERLY
State : TN
Zip : 37185-3002
Country : US
Telephone Number : 731-358-3084
Fax Number :
Provider Business Practice Location Address
First Line : 111 IMPERIAL BLVD
Second Line :
City : HENDERSONVILLE
State : TN
Zip : 37075-3400
Country : US
Telephone Number : 615-560-6622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2023
Last Update Date : 12/06/2024

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Directions to “ MORGAN WALL ” Practice Location

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