Individual
ANDREA LYNNE WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
168 N JOHNSTON ST, DALLAS, GA 30132-4739
(877) 498-0319
Mailing address
168 N JOHNSTON ST, DALLAS, GA 30132-4739
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
GA
Other
Enumeration date
08/30/2024
Last updated
08/30/2024
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