Healthcare Provider Details

I. General information

NPI: 1467372169
Provider Name (Legal Business Name): WALK WITH US WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 ALLIED DR STE 303
DEDHAM MA
02026-6148
US

IV. Provider business mailing address

3 ALLIED DR STE 303
DEDHAM MA
02026-6148
US

V. Phone/Fax

Practice location:
  • Phone: 617-352-4414
  • Fax: 509-834-7419
Mailing address:
  • Phone: 617-352-4414
  • Fax: 509-834-7419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: DANIELLE TANIKA WALKER
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: NP
Phone: 617-352-4414