Provider Information for 1225231202
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ELIZABETH WALDEN LPC
Sex: Female
NPI: 1225231202
Last Updated: 2024-02-08
Certification Date: 2024-02-08
Certification Date: 2024-02-08
Details
| Name | Value | ||||||||||||
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| NPI | 1225231202 | ||||||||||||
| Enumeration Date | 2007-06-07 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 6705 FOXCROFT RD PROSPECT, KY 40059-9128 United States Phone: 502-523-9915 | Fax: | ||||||||||||
| Primary Practice Address | 6705 FOXCROFT RD PROSPECT, KY 40059-9128 United States Phone: 502-523-9915 | Fax: | ||||||||||||
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