Individual
MS. CHARLOTTE REEVES WALYKO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA, LPA
Contact information
Practice address
854 COUNTRY CLUB RD, ROCKY MOUNT, NC 27804-1706
(252) 972-9903
(252) 451-1540
Mailing address
PO BOX 2161, ROANOKE RAPIDS, NC 27870-7161
(252) 537-6164
(252) 537-9199
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1699
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04579
BCBS
NC
05
—
6107008
—
NC
Enumeration date
04/14/2006
Last updated
07/08/2007
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