Doctor Name: | SUSAN WALTERS |
NPI Number: | 1326265612 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 6453 |
Business Practice Address: | 32 Common St Walpole, MA - 020812803 |
Business Phone Number: | 5086683223 |
Business Fax Number: | |
Mailing Address: | 32 Common St, WALPOLE |
State: | MA |
Postal Code: | 020812803 |
Phone Number: | 5086683223 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 01/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6453 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |