Individual
DR. MICHAEL R WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD, LP
Contact information
Practice address
301 FISHER ST, BILOXI, MS 39534-2508
(228) 377-6550
Mailing address
301 FISHER ST, BILOXI, MS 39534-2508
(228) 377-6550
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2010040768
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490004794
—
MO
Enumeration date
07/13/2006
Last updated
01/17/2023
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