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General NPI Number Information
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NPI Number | 1255089397
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Entity Type | Individual
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Provider Name | RHONDA ELLEN WALSH LCAS-A
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Gender | Female
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 1790 METROMEDICAL DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3861
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Country | US
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Telephone | 910-745-8895
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Fax | 910-758-8254
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Provider Business Mailing Address
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Address Line | 740 POOLE DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-4234
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Country | US
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Telephone | 386-222-8872
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Fax | 910-758-8254
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-27923
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License Number State | NC
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