Individual
SUSAN ELIZABETH WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
167 CLERMONT AVE, BROOKLYN, NY 11205-3303
(516) 698-2431
Mailing address
384 MYRTLE AVE, BROOKLYN, NY 11205-2465
(516) 698-2431
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
001403
NY
Other
Enumeration date
03/17/2011
Last updated
03/31/2011
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