Basic Information
| Provider Information | |||||||||
| NPI: | 1548274046 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WALMER | ||||||||
| FirstName: | DARRELL | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | MA LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 108 S MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | MANHEIM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175451602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176652675 | ||||||||
| FaxNumber: | 7176656193 | ||||||||
| Practice Location | |||||||||
| Address1: | 108 S MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | MANHEIM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 175451602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176652675 | ||||||||
| FaxNumber: | 7176656193 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | PC003943 | PA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.