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NPI Code Detail

MEDICARE: THERESE WALSH

MEDICARE: THERESE WALSH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorPC010849PA

General Provider Information

NPI Number : 1033768916
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESE WALSH
Provider Business Mailing Address
First Line : 1000 JEFFERSON ST STE 2C
Second Line :
City : LYNCHBURG
State : VA
Zip : 24504-1724
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1800 JOHN F KENNEDY BLVD STE 1404
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-7417
Country : US
Telephone Number : 215-732-2306
Fax Number : 617-807-0958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2019
Last Update Date : 09/04/2019

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Directions to “ THERESE WALSH ” Practice Location

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