Individual
KIMBERLY D WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5501 DELMAR BLVD STE B300, SAINT LOUIS, MO 63112-3078
(314) 469-4908
Mailing address
5501 DELMAR BLVD STE B300, SAINT LOUIS, MO 63112-3078
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435201
—
SC
Enumeration date
02/10/2021
Last updated
01/31/2025
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