Provider Demographics
NPI:1568088367
Name:WALTON, VERONICA OCTAVIA (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:OCTAVIA
Last Name:WALTON
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-5263
Mailing Address - Country:US
Mailing Address - Phone:303-630-9144
Mailing Address - Fax:
Practice Address - Street 1:777 HOLLY ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-5263
Practice Address - Country:US
Practice Address - Phone:303-630-9144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0002007106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist