Provider Demographics
NPI:1467103838
Name:WALSH, KATHARINE ELIZABETH MILLER (CET I)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ELIZABETH MILLER
Last Name:WALSH
Suffix:
Gender:F
Credentials:CET I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 S 50TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-3305
Mailing Address - Country:US
Mailing Address - Phone:610-731-8785
Mailing Address - Fax:
Practice Address - Street 1:524 N PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3056
Practice Address - Country:US
Practice Address - Phone:484-440-9416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program