Healthcare Provider Details

I. General information

NPI: 1629331582
Provider Name (Legal Business Name): TONI WALKER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2012
Last Update Date: 06/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10048 LORALINDA DR
CINCINNATI OH
45251-1351
US

IV. Provider business mailing address

10048 LORALINDA DR
CINCINNATI OH
45251-1351
US

V. Phone/Fax

Practice location:
  • Phone: 513-741-4080
  • Fax:
Mailing address:
  • Phone: 513-741-4080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License NumberPN 125041-M-IV
License Number StateOH

VIII. Authorized Official

Name: MS. TONI L WALKER
Title or Position: LPN
Credential: NURSE
Phone: 513-481-2201