Provider Demographics
NPI:1639151731
Name:WALSH, DANIELA M (PT)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:M
Last Name:WALSH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 EAST AVE
Mailing Address - Street 2:SUITE 2M
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5721
Mailing Address - Country:US
Mailing Address - Phone:203-866-5458
Mailing Address - Fax:203-354-6182
Practice Address - Street 1:195 DANBURY RD
Practice Address - Street 2:BUILDING B, 2ND FLOOR
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4003
Practice Address - Country:US
Practice Address - Phone:203-834-8884
Practice Address - Fax:203-563-9675
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006719225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist