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NPI Code Detail

MEDICARE: MRS. BETTY R. WALTON M.A. CCC-SLP

MEDICARE: MRS. BETTY R. WALTON M.A. CCC-SLP
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
1235Z00000XSpeech-Language Pathologist2202001260VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962679118
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BETTY R. WALTON M.A. CCC-SLP
Provider Business Mailing Address
First Line : PO BOX 6204
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23606-0204
Country : US
Telephone Number : 757-871-5558
Fax Number : 844-336-3309
Provider Business Practice Location Address
First Line : 4410 CLAIBORNE SQ E STE 334
Second Line :
City : HAMPTON
State : VA
Zip : 23666-2074
Country : US
Telephone Number : 757-871-5558
Fax Number : 844-336-3309
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2008
Last Update Date : 02/06/2017

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