Individual
MS. MELISSA MARIE WALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
323 S COURT ST, MEDINA, OH 44256-3715
(330) 331-5800
Mailing address
1192 GOLD CREST DR, MEDINA, OH 44256-4106
(330) 635-3801
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C.1801520
OH
103TC0700X
Clinical Psychologist
Primary
P.07896
OH
Other
Enumeration date
10/13/2018
Last updated
06/24/2019
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