Provider Demographics
NPI:1689996597
Name:WALTER, YEN (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:YEN
Middle Name:
Last Name:WALTER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1957 W CARSON ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-3282
Mailing Address - Country:US
Mailing Address - Phone:888-268-0269
Mailing Address - Fax:888-864-1682
Practice Address - Street 1:1957 W CARSON ST
Practice Address - Street 2:SUITE 103
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-3282
Practice Address - Country:US
Practice Address - Phone:888-268-0269
Practice Address - Fax:888-864-1682
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP10805235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist