Individual
MRS. MARSHA LYNN WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
111 W ANDERSON LN, SUITE C100, ROUND ROCK, TX 78680
(512) 451-0961
(512) 451-9745
Mailing address
PO BOX 2353, ROUND ROCK, TX 78680-2353
(512) 451-0961
(512) 451-9745
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
109393
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86808T
BCBS PROVIDER ID
TN
Enumeration date
09/21/2006
Last updated
07/08/2007
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