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Aspin Walta
Mental Health Counselor in Centralia, Illinois
NPI 1083348825

Aspin Walta is a Mental Health Counselor based in Centralia, IL and is specialized in Mental Health. Aspin Walta practices in Centralia, IL. The NPI Number for Aspin Walta is 1083348825 and holds a License No. (Illinois).

The current practice location address for Aspin Walta is 904 M L King Dr, Centralia, IL and can be reached out via phone at 618-533-1391 and via fax at 618-533-0012.

Location: 904 M L King Dr, Centralia, IL, 62801-3058
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1083348825
Provider Name
Aspin Walta
Credential
Provider Entity Type
Individual
Gender
Female
Address
904 M L King Dr, Centralia, IL, 62801-3058
Phone Number
618-533-1391
Fax Number
618-533-0012
Provider Enumeration Date
07/15/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
370915481007 05 IL
institution
Provider Business Practice Location Address Details
Address
904 M L King Dr
City
Centralia
State
Illinois
Zip
62801-3058
Phone Number
618-533-1391
Fax Number
618-533-0012
person
Provider Business Mailing Address Details
Address
904 M L King Dr
City
Centralia
State
Illinois
Zip
62801-3058
Phone Number
618-533-1391
Fax Number
618-533-0012
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
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Definition
Definition to come...
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