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General NPI Number Information
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NPI Number | 1912055146
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Entity Type | Individual
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Provider Name | KRISTI LYNNE WALSH PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | N70W6946 BRIDGE RD
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City | CEDARBURG
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State | WI
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Zip | 53012-1814
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Country | US
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Telephone | 805-722-5221
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Fax |
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Provider Business Mailing Address
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Address Line | 911 E COLORADO BLVD STE 200
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City | PASADENA
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State | CA
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Zip | 91106-1773
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Country | US
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Telephone | 626-755-0042
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT25211
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | 1471-124
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License Number State | WI
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