| Doctor Name: | DOUGLAS A WALTER |
| NPI Number: | 1467765305 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 2240 |
| Business Practice Address: | 1010 N Breazeale Ave Unit C Mount Olive, NC - 283651106 |
| Business Phone Number: | 9196587500 |
| Business Fax Number: | 9196587509 |
| Mailing Address: | Po Box 427, MOUNT OLIVE |
| State: | NC |
| Postal Code: | 283650427 |
| Phone Number: | 9196587500 |
| Fax Number: | 9196587509 |
| NPI Enumeration Date: | 07/21/2010 |
| NPI Last Update Date: | 07/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2240 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |