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Individual
DR. MIRIAM S. WALD
Active
Individual
DR. MIRIAM S. WALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY10413
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PL104130
BLUE CROSS BLUE SHIELD
CA
01
—
680006644
RAIL ROAD
CA
05
—
PSY104130
—
CA
Enumeration date
10/19/2006
Last updated
07/08/2007
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