Individual
DANA LYNN WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
734 MADISON AVE, FORT ATKINSON, WI 53538-1361
(920) 563-9375
(920) 563-9376
Mailing address
734 MADISON AVE, FORT ATKINSON, WI 53538-1361
(920) 563-9375
(920) 563-9376
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3116-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39663200
—
WI
Enumeration date
05/04/2011
Last updated
05/04/2011
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