Doctor Name: | MS. JENNIE WALKER |
NPI Number: | 1124304514 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.P.C. |
License Number: | L1570122 |
Business Practice Address: | 204 Meadows Dr Grayling, MI - 497382013 |
Business Phone Number: | 9893488522 |
Business Fax Number: | 9893486434 |
Mailing Address: | 204 Meadows Dr, GRAYLING |
State: | MI |
Postal Code: | 497382013 |
Phone Number: | 9893488522 |
Fax Number: | 9893486434 |
NPI Enumeration Date: | 10/29/2011 |
NPI Last Update Date: | 10/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | L1570122 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |