Individual
MR. GREGORY DAVID WALSH
Active
Individual
MR. GREGORY DAVID WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
9379
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0488739-00
—
MN
05
—
048873900
—
MN
01
—
6236362
MEDICA-UBH
—
Enumeration date
07/05/2006
Last updated
08/11/2010
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