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General NPI Number Information
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NPI Number | 1962679118
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Entity Type | Individual
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Provider Name | BETTY R. WALTON M.A. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 02/06/2017
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Provider Practice Location Address
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Address Line | 4410 CLAIBORNE SQ E STE 334
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City | HAMPTON
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State | VA
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Zip | 23666-2074
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Country | US
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Telephone | 757-871-5558
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Fax | 844-336-3309
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Provider Business Mailing Address
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Address Line | PO BOX 6204
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-0204
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Country | US
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Telephone | 757-871-5558
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Fax | 844-336-3309
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202001260
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License Number State | VA
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