Provider Demographics
NPI:1609580133
Name:WALDEN, ALEIGHA (MAT STUDENT)
Entity Type:Individual
Prefix:
First Name:ALEIGHA
Middle Name:
Last Name:WALDEN
Suffix:
Gender:F
Credentials:MAT STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4195 CAMELLIA DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-3002
Mailing Address - Country:US
Mailing Address - Phone:334-462-4491
Mailing Address - Fax:
Practice Address - Street 1:4195 CAMELLIA DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-3002
Practice Address - Country:US
Practice Address - Phone:334-328-8414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer