Individual
WALTERS ITIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1445 HOWARD RD SE, WASHINGTON, DC 20020-4406
(202) 352-2914
Mailing address
4921 COLLINGTONS BOUNTY DR, BOWIE, MD 20720-5627
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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