Healthcare Provider Details

I. General information

NPI: 1376400820
Provider Name (Legal Business Name): SERENITY FAITH WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G4476 S DORT HWY
BURTON MI
48529-1806
US

IV. Provider business mailing address

6039 FOUNTAIN POINTE APT 12
GRAND BLANC MI
48439-7766
US

V. Phone/Fax

Practice location:
  • Phone: 810-344-8082
  • Fax:
Mailing address:
  • Phone: 636-345-3897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: