Individual
DANIEL T WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
3300 ACADEMY AVE, ACADEMY CROSSING MEDICAL PLAZA, PORTSMOUTH, VA 23703-3205
(757) 483-6404
(757) 483-0737
Mailing address
3300 ACADEMY AVE, ACADEMY CROSSING MEDICAL PLAZA, PORTSMOUTH, VA 23703-3205
(757) 483-6404
(757) 483-0737
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001355
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007702311
—
VA
01
—
085262
SENTARA
VA
01
—
331838
ANTHEM
VA
Enumeration date
11/28/2005
Last updated
12/15/2010
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