Individual
KATHRYN ROSE WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
38 MAINSAIL DR APT 2-38, PATCHOGUE, NY 11772-3434
(631) 291-0332
Mailing address
38 MAINSAIL DR APT 2-38, PATCHOGUE, NY 11772-3434
(631) 291-0332
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
3518617
NY
Other
Enumeration date
09/12/2014
Last updated
09/12/2014
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