Provider Demographics
NPI:1336469923
Name:WALTERS, JULIET
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:WALTERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 UNIVERSITY DR
Mailing Address - Street 2:24-H
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6124
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1804 MARTIN LUTHER KING PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3587
Practice Address - Country:US
Practice Address - Phone:919-489-2254
Practice Address - Fax:919-403-1551
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist