Individual
MS. AMY LOUISE WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW MSW
Contact information
Practice address
116 MADISON ST, ITHACA, NY 14850-3430
(607) 229-2845
Mailing address
116 MADISON ST, ITHACA, NY 14850-3430
(607) 229-2845
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
074228
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01079267
—
NY
Enumeration date
10/12/2006
Last updated
06/27/2013
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