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General NPI Number Information
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NPI Number | 1205042942
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Entity Type | Individual
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Provider Name | ANN KATHRYN WALTER MFT MARRIAGE & FAMIL
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1780 B CENTURY BLVD
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City | ATLANTA
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State | GA
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Zip | 30345-3399
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Country | US
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Telephone | 404-633-0071
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Fax |
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Provider Business Mailing Address
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Address Line | 1917 WESTMINSTER WAY
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City | ATLANTA
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State | GA
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Zip | 30307-1136
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Country | US
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Telephone | 404-315-7559
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Fax | 404-315-7559
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 572
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | M14389
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License Number State | CA
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