Individual
CRYSTAL WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASTERS
Contact information
Practice address
175 MAYFIELD DR, BOYDTON, VA 23917-2817
(424) 210-6201
Mailing address
PO BOX 190, BOYDTON, VA 23917-0190
(424) 210-6201
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
0813000438
VA
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0813000438
—
VA
Enumeration date
03/09/2018
Last updated
03/09/2018
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