Provider Demographics
NPI:1528264066
Name:WALTHER, DEBRA JOAN (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:JOAN
Last Name:WALTHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 P ST NW
Mailing Address - Street 2:302
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5948
Mailing Address - Country:US
Mailing Address - Phone:202-466-5538
Mailing Address - Fax:202-466-5546
Practice Address - Street 1:2029 P ST NW
Practice Address - Street 2:302
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5948
Practice Address - Country:US
Practice Address - Phone:202-466-5538
Practice Address - Fax:202-466-5546
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1700103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist