Individual
MR. TIMOTHY WALSH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PC011354
STATE LICENSE
PA
Enumeration date
02/28/2018
Last updated
06/30/2025
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