| Diana L. Walther, Ph.d. Pc | |
|
1421 Lee St Brunswick GA 31520-7132 | |
| (912) 265-0007 | |
| (912) 261-0593 |
| Full Name | Diana L. Walther, Ph.d. Pc |
|---|---|
| Speciality | Psychologist |
| Location | 1421 Lee St, Brunswick, Georgia |
| Authorized Official Name and Position | Diana L Walther (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 9122650007 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diana L. Walther, Ph.d. Pc 1421 Lee St Brunswick GA 31520-7132 Ph: (912) 265-0007 | Diana L. Walther, Ph.d. Pc 1421 Lee St Brunswick GA 31520-7132 Ph: (912) 265-0007 |
| NPI Number | 1568625747 |
|---|---|
| Provider Enumeration Date | 07/08/2008 |
| Last Update Date | 07/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568625747 | NPI | - | NPPES |
| 10049299 | Other | GA | AMERIGROUP |
| 000829606D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY002320 (Georgia) | Primary |
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