Healthcare Provider Details

I. General information

NPI: 1801186655
Provider Name (Legal Business Name): ROBIN WALTERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2011
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1673 TULIP AVE
DISTRICT HEIGHTS MD
20747-2615
US

IV. Provider business mailing address

1673 TULIP AVE
DISTRICT HEIGHTS MD
20747-2615
US

V. Phone/Fax

Practice location:
  • Phone: 301-537-7556
  • Fax:
Mailing address:
  • Phone: 301-537-7556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP17634
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: