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Individual

JILL WALTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
500 W 10TH ST, WILMINGTON, DE 19801-1422
(302) 230-9157
(302) 984-3324
Mailing address
349 SCOLA RD, BROOKHAVEN, PA 19015-1417
(484) 480-8900

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
750
DE
101YM0800X
Mental Health Counselor
Primary
CD-0000035
PA

Other

Enumeration date
06/30/2014
Last updated
06/30/2014
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