SearchMissouri101YP2500X

Derek Wall, M.S., LPC, NCC

NPI 1639408214 · on the registry since 2009 · sole proprietor

Practice

Address
12400 Olive Blvd
Suite 205
Saint Louis, MO 63141
Phone
(314) 607-2801
Organisation at this address
Gateway Anesthesia Partners Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
9

Registry record

Primary taxonomy
101YP2500X
101YP2500X
Also registered as
101YP2500X
Licence states on file
MO, IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2009-12-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri