Provider Demographics
NPI:1770819716
Name:WALSH, EVELYN
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:WALSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 FARMHOUSE LANE
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036
Mailing Address - Country:US
Mailing Address - Phone:717-566-6190
Mailing Address - Fax:
Practice Address - Street 1:960 CENTURY DRIVE
Practice Address - Street 2:DIAKON FLS
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055
Practice Address - Country:US
Practice Address - Phone:717-795-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor