Provider Demographics
NPI:1538491675
Name:WALTERS, DOROTHY J (AUD)
Entity type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:J
Last Name:WALTERS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:DOTTY
Other - Middle Name:J
Other - Last Name:WALTERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:4217 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50311-3421
Mailing Address - Country:US
Mailing Address - Phone:515-255-2300
Mailing Address - Fax:515-255-1701
Practice Address - Street 1:4217 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50311-3421
Practice Address - Country:US
Practice Address - Phone:515-255-2300
Practice Address - Fax:515-255-1701
Is Sole Proprietor?:No
Enumeration Date:2010-01-30
Last Update Date:2010-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00371231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist