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Individual
MR. WALTER CARLSON
Active
Individual
MR. WALTER CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED., CADC, LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6409
IL
101YP2500X
Professional Counselor
Primary
180003891
IL
Other
Enumeration date
01/31/2011
Last updated
01/31/2011
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