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Organization
AUDRA WALSH, PHD, LLC
Active
Organization
AUDRA WALSH, PHD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUDRA WALSH PHD (LICENSED PSYCHOLOGIST)
(727) 599-3624
Entity
Organization
Contact information
Practice address
1039 PARK ST N, ST PETERSBURG, FL 33710-4317
(727) 599-3624
Mailing address
1039 PARK ST N, ST PETERSBURG, FL 33710-4317
(727) 599-3624
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY9148
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY9751
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205249752
—
FL
05
—
1477710416
—
FL
Enumeration date
12/04/2017
Last updated
12/04/2017
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