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General NPI Number Information
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NPI Number | 1144593773
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Entity Type | Individual
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Provider Name | EMILY MARY NELSON WALSH LICSW
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Gender | Female
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Dates
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Enumeration Date | 02/13/2012
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 90 WASHINGTON ST STE 301B
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City | DOVER
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State | NH
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Zip | 03820-3744
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Country | US
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Telephone | 603-836-0393
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1604
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City | DOVER
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State | NH
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Zip | 03821-1604
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Country | US
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Telephone | 603-836-0393
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2482
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C008567
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License Number State | NC
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