Most Relevant Information
Provider Data
| NPI Number: | 1003650581 |
| Provider Name: | KAITLYN LIPSCOMB WALL M.S, ED.S., NCSP |
| Entity Type: | Individual |
| Taxonomy Code: | 103TS0200X |
| Specialty: | Psychologist |
| License Number: | PPS-0608310 |
Most Important Dates
| Enumeration Date: | 06/20/2024 |
| Last Updated: | 06/20/2024 |
Provider Practice Location
39 BANK ST
CHATHAM
VA
245311129
Practice Location Phone/Fax
| Phone: | 4344322761 |
| Fax: |
Provider Mailing Location
39 BANK ST
CHATHAM
VA
245311129
Provider Mailing Phone/Fax
| Phone: | 4344322761 |
| Fax: |