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Individual

DERREKA J WALTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSE LPC

Contact information

Practice address
806 VALLEY RD STE 13, MENASHA, WI 54952-1012
(920) 872-7292
(920) 872-7066
Mailing address
806 VALLEY RD STE 13, MENASHA, WI 54952-1012
(920) 872-7292
(920) 872-7066

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4757-125
WI

Other

Enumeration date
02/09/2021
Last updated
04/26/2021
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