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General NPI Number Information
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NPI Number | 1972013522
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Entity Type | Organization
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Legal Business Name | JACQUELYN A WALTHER, LPC, NCC
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Dates
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Enumeration Date | 10/10/2017
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 3005 HARVARD AVE STE 201
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City | METAIRIE
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State | LA
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Zip | 70006-6401
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Country | US
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Telephone | 504-915-0147
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Fax |
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Provider Business Mailing Address
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Address Line | 5216 WILLOWTREE RD
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City | MARRERO
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State | LA
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Zip | 70072-4943
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Country | US
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Telephone | 504-915-0147
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Fax |
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Authorized Official
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Title or Position | LPC
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Name | MRS. JACQUELYN A WALTHER
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Credential | LPC
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Telephone | 504-915-0147
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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 |
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License Number State |
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