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Individual

EBAN WALTERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
4401 VETERANS MEMORIAL BLVD, SUITE 201, METAIRIE, LA 70006-5340
(504) 302-3226
(504) 267-0298
Mailing address
7608 WILLOW ST, NEW ORLEANS, LA 70118-4052
(504) 302-3226

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1150
LA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1150
LA

Other

Enumeration date
04/26/2011
Last updated
06/03/2013
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