Doctor Name: | MR. JOHN WALKER |
NPI Number: | 1134294291 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | LPC 2974 |
Business Practice Address: | 102 Commons Blvd Ste C Piedmont, SC - 296737766 |
Business Phone Number: | 8642209115 |
Business Fax Number: | 8642209513 |
Mailing Address: | 12 Polly St, HONEA PATH |
State: | SC |
Postal Code: | 296541920 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC 2974 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |