Eric Lee Nelson Wallen, LMSW

NPI #1114556081 in Bonne Terre, Missouri

Provider Information

NPI Number: 1114556081
Entity Type: Individual
Name: Eric Lee Nelson Wallen, LMSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: LMSW
Enumeration Date: Apr 3, 2020
Last Updated: Apr 3, 2020

Practice Location

Address: 11 S DIVISION ST
City: Bonne Terre
State: Missouri
ZIP Code: 63628-1772
Phone: (573) 723-1100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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