Provider Demographics
NPI:1497192991
Name:WALTER, PRECIOUS UNIQUE (SOCIAL WORKER)
Entity Type:Individual
Prefix:MRS
First Name:PRECIOUS
Middle Name:UNIQUE
Last Name:WALTER
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1253
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-0024
Mailing Address - Country:US
Mailing Address - Phone:678-876-7596
Mailing Address - Fax:
Practice Address - Street 1:2085 CUTLEAF CREEK RD
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017-4166
Practice Address - Country:US
Practice Address - Phone:678-876-7596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW006063251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management