Walters, Kenneth S.

Walters, Kenneth S. is an sole proprietor health care provider with primary practice located at 15 Farone Dr Apt B11 , Oneonta NY 13820-1337. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Walters, Kenneth S. can be contacted via phone (607) 267-7480.

Contact Information

Primary practice address
15 Farone Dr Apt B11 Oneonta NY 13820-1337
Phone: (607) 267-7480
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PS1102 Maine

Profile Details

NPI number 1134162365
LBN Legal business name Walters, Kenneth S.
Credentials PH,D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Jul 15th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134162365 NPPES
Maine Other 098303 ANTHEM LEGACY NUMBER
Maine MEDICAID 403260099 ANTHEM LEGACY NUMBER

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