Doctor Name: | MR. KENNETH EDWARD WALKAMA |
NPI Number: | 1467501726 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A., M.DIV. |
License Number: | |
Business Practice Address: | 587 E Middle Tpke Manchester, CT - 060403731 |
Business Phone Number: | 8606463888 |
Business Fax Number: | 8606454132 |
Mailing Address: | 167 Griswold Dr, WEST HARTFORD |
State: | CT |
Postal Code: | 061191020 |
Phone Number: | 8602367167 |
Fax Number: | |
NPI Enumeration Date: | 01/09/2007 |
NPI Last Update Date: | 05/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |