Doctor Name: | WALTER JAMES BUTCHER |
NPI Number: | 1164702841 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MFT |
License Number: | 47926 |
Business Practice Address: | 8505 Saran Dr Playa Del Rey, CA - 902938413 |
Business Phone Number: | 3102831486 |
Business Fax Number: | |
Mailing Address: | 8117 W Manchester Ave, #175 PLAYA DEL REY |
State: | CA |
Postal Code: | 902938745 |
Phone Number: | 3102831486 |
Fax Number: | |
NPI Enumeration Date: | 08/25/2011 |
NPI Last Update Date: | 08/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 47926 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |