Basic Information
| Provider Information | |||||||||
| NPI: | 1598224214 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WALSH | ||||||||
| FirstName: | VICTORIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 613 CRICKLEWOOD RD | ||||||||
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| City: | WEST CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193828507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4842660387 | ||||||||
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| Practice Location | |||||||||
| Address1: | 333 S NEWTOWN STREET RD | ||||||||
| Address2: | |||||||||
| City: | NEWTOWN SQUARE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190734400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103255400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2019 | ||||||||
| LastUpdateDate: | 03/13/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC016138 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.