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General NPI Number Information
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NPI Number | 1184383192
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Entity Type | Organization
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Legal Business Name | COREY WALMER, LLC
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Dates
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Enumeration Date | 12/17/2021
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 40 FOREST FALLS DR STE 9
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City | YARMOUTH
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State | ME
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Zip | 04096-7005
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Country | US
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Telephone | 207-491-9456
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Fax |
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Provider Business Mailing Address
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Address Line | 40 FOREST FALLS DR STE 9
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City | YARMOUTH
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State | ME
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Zip | 04096-7005
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | COREY WALMER
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Credential |
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Telephone | 207-491-9456
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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 |
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License Number State |
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