Organization
SANDRA BUNCH WALTON
Active
Other names
Life Quest
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA BUNCH WALTON LMFT, CNS (OWNER/PROVIDER)
(252) 758-4554
Entity
Organization
Contact information
Practice address
1990 ALLEN RD, SUITE B, GREENVILLE, NC 27834-0058
(252) 758-4554
(252) 758-5561
Mailing address
1990 ALLEN RD, SUITE B, GREENVILLE, NC 27834-0058
(252) 758-4554
(252) 758-5561
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126AM
BCBS
NC
Enumeration date
10/11/2005
Last updated
08/22/2020
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