Audra Walsh, Phd, Llc | |
1039 Park St N St Petersburg FL 33710-4317 | |
(727) 599-3624 | |
Not Available |
Full Name | Audra Walsh, Phd, Llc |
---|---|
Speciality | Psychologist - Clinical Child & Adolescent |
Location | 1039 Park St N, St Petersburg, Florida |
Authorized Official Name and Position | Audra Walsh (LICENSED PSYCHOLOGIST) |
Authorized Official Contact | 7275993624 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Audra Walsh, Phd, Llc 1039 Park St N St Petersburg FL 33710-4317 Ph: (727) 599-3624 | Audra Walsh, Phd, Llc 1039 Park St N St Petersburg FL 33710-4317 Ph: (727) 599-3624 |
NPI Number | 1073028734 |
---|---|
Provider Enumeration Date | 12/04/2017 |
Last Update Date | 12/04/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073028734 | NPI | - | NPPES |
1205249752 | Medicaid | FL | |
1477710416 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC2200X | Psychologist - Clinical Child & Adolescent | PY9148 (Florida) | Primary |
103TC2200X | Psychologist - Clinical Child & Adolescent | PY9751 (Florida) | Secondary |
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