Doctor Name: | BIRDA LEE WALKER |
NPI Number: | 1003980392 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LLP |
License Number: | 6301005505 |
Business Practice Address: | 300 South St. Kalamazoo, MI - 49007 |
Business Phone Number: | 2693534588 |
Business Fax Number: | 2693534588 |
Mailing Address: | 4805 Briarhill Dr, PORTAGE |
State: | MI |
Postal Code: | 490249537 |
Phone Number: | 2693534588 |
Fax Number: | 2693534588 |
NPI Enumeration Date: | 11/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6301005505 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |