Healthcare Provider Details

I. General information

NPI: 1225479322
Provider Name (Legal Business Name): CYNTHIA WALKER MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2013
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 ELK CREEK DR
IDAHO FALLS ID
83404-8237
US

IV. Provider business mailing address

1415 WHITEWATER DR APT 3302
IDAHO FALLS ID
83402-5932
US

V. Phone/Fax

Practice location:
  • Phone: 208-535-1286
  • Fax:
Mailing address:
  • Phone: 208-431-9967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP-1390
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: