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General NPI Number Information
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NPI Number | 1487186110
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Entity Type | Organization
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Legal Business Name | DARBY WALTON
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Dates
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Enumeration Date | 03/31/2017
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Last Update Date | 03/31/2017
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Provider Practice Location Address
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Address Line | 6858 SWINNEA RD
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City | SOUTHAVEN
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State | MS
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Zip | 38671-9493
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Country | US
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Telephone | 662-536-6210
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Fax |
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Provider Business Mailing Address
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Address Line | 6573 WHITE HAWK LN
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-6387
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Country | US
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Telephone | 662-710-8570
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | DARBY D WALTON
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Credential | LPC, NCC, CADC-I
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Telephone | 662-710-8570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2122
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License Number State | MS
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