Individual
SUSAN WALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6150 METROWEST BLVD STE 305, ORLANDO, FL 32835-3291
(754) 400-5514
Mailing address
1000 JEFFERSON ST STE 2C, LYNCHBURG, VA 24504-1724
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MT1647
—
Other
Enumeration date
01/20/2021
Last updated
01/20/2021
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