Provider Demographics
NPI:1316305907
Name:WALSH, CAROL STRUCKMEYER (MS, LGC)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:STRUCKMEYER
Last Name:WALSH
Suffix:
Gender:F
Credentials:MS, LGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 MCGREGOR STREET
Mailing Address - Street 2:SUITE 4100, NORRIS COTTON CANCER CENTER
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3765
Mailing Address - Country:US
Mailing Address - Phone:603-629-8752
Mailing Address - Fax:603-695-2855
Practice Address - Street 1:87 MCGREGOR STREET
Practice Address - Street 2:SUITE 4100, NORRIS COTTON CANCER CENTER
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3765
Practice Address - Country:US
Practice Address - Phone:603-629-8752
Practice Address - Fax:603-695-2855
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0006170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS