Individual
DR. MARIANNE F WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
222 PROSPECT AVE, SEA CLIFF, NY 11579-1048
(516) 671-3830
Mailing address
222 PROSPECT AVE, SEA CLIFF, NY 11579-1048
(516) 609-0374
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
014114-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02096353
—
NY
Enumeration date
12/11/2006
Last updated
07/08/2007
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