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NPI Code Detail

MEDICARE: MRS. TERRIE LYNN WALKER MS

MEDICARE: MRS. TERRIE LYNN WALKER MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorIN

General Provider Information

NPI Number : 1952488702
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TERRIE LYNN WALKER MS
Provider Business Mailing Address
First Line : 8003 GLENOAK PKWY
Second Line :
City : FORT WAYNE
State : IN
Zip : 46815-6563
Country : US
Telephone Number : 260-749-9859
Fax Number :
Provider Business Practice Location Address
First Line : 2821 HILLEGAS RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46808-3859
Country : US
Telephone Number : 260-471-1950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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