Healthcare Provider Details

I. General information

NPI: 1003556606
Provider Name (Legal Business Name): RAMONA J WALTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 03/31/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 S WASHINGTON ST STE 100
NAPERVILLE IL
60540-7960
US

IV. Provider business mailing address

PO BOX 382
DEKALB IL
60115-0382
US

V. Phone/Fax

Practice location:
  • Phone: 331-826-0226
  • Fax:
Mailing address:
  • Phone: 919-758-3015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: