Provider Demographics
NPI:1003623687
Name:WALTERS, AMAYA
Entity type:Individual
Prefix:
First Name:AMAYA
Middle Name:
Last Name:WALTERS
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 1:1700 E COLD SPRING LN # 743
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21251-0002
Mailing Address - Country:US
Mailing Address - Phone:551-804-1606
Mailing Address - Fax:
Practice Address - Street 1:1700 E COLD SPRING LN # 743
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21251-6236
Practice Address - Country:US
Practice Address - Phone:551-804-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician