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NPI Code Detail

MEDICARE: DR. CHAILLE ANNE WALSH PH.D.

MEDICARE: DR. CHAILLE ANNE WALSH PH.D.
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
1103T00000XPsychologist3309NC

General Provider Information

NPI Number : 1851555767
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHAILLE ANNE WALSH PH.D.
Provider Business Mailing Address
First Line : 2020 W MAIN ST
Second Line :
City : DURHAM
State : NC
Zip : 27705-4683
Country : US
Telephone Number : 919-286-3453
Fax Number : 919-286-7033
Provider Business Practice Location Address
First Line : 2020 W MAIN ST
Second Line :
City : DURHAM
State : NC
Zip : 27705-4683
Country : US
Telephone Number : 919-286-3453
Fax Number : 919-286-7033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2008
Last Update Date : 07/10/2008

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