Individual
ENEZIAH WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2111 UNIVERSITY PARK DR STE 400, OKEMOS, MI 48864-6907
(517) 512-5289
Mailing address
134 W MAPLE ST, MASON, MI 48854-1657
(517) 676-9788
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6801102859
MI
104100000X
Social Worker
Primary
6801108006
MI
Other
Enumeration date
05/29/2019
Last updated
11/27/2023
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