Individual
DERRICIA WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 E DUPONT RD, FORT WAYNE, IN 46825-1554
(260) 471-8141
Mailing address
5402 S CALHOUN ST, FORT WAYNE, IN 46807-3317
(260) 206-4424
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39005938A
IN
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/24/2023
Last updated
03/25/2026
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