Individual
REBECCA WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
96 CIRCUS LN, CANTON, PA 17724-7216
(607) 742-1497
Mailing address
96 CIRCUS LN, CANTON, PA 17724-7216
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW130172
PA
Other
Enumeration date
05/22/2024
Last updated
05/22/2024
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