| Doctor Name: | DR. LARRY DEAN WALKER |
| NPI Number: | 1982656831 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | MH5282 |
| Business Practice Address: | 820 Ebenezer Church Rd Ste 110 Sharpsburg, GA - 302772073 |
| Business Phone Number: | 7068893997 |
| Business Fax Number: | 8885017276 |
| Mailing Address: | Po Box 72616, NEWNAN |
| State: | GA |
| Postal Code: | 302712616 |
| Phone Number: | 7068893997 |
| Fax Number: | 8885017276 |
| NPI Enumeration Date: | 05/17/2006 |
| NPI Last Update Date: | 06/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH5282 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |