Provider Demographics
NPI:1245543784
Name:WALSH, LEORAH MIRI (MD)
Entity type:Individual
Prefix:DR
First Name:LEORAH
Middle Name:MIRI
Last Name:WALSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1 BALA AVE STE 308
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-3210
Mailing Address - Country:US
Mailing Address - Phone:215-484-3855
Mailing Address - Fax:610-982-7006
Practice Address - Street 1:1 BALA AVE STE 308
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3210
Practice Address - Country:US
Practice Address - Phone:215-484-3855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4589032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry