Healthcare Provider Details

I. General information

NPI: 1013750116
Provider Name (Legal Business Name): ANNAMAE WALKER M.S. OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2104 ASPEN DR
MECHANICSBURG PA
17055-5507
US

IV. Provider business mailing address

406 E MARBLE ST
MECHANICSBURG PA
17055-4265
US

V. Phone/Fax

Practice location:
  • Phone: 717-506-5668
  • Fax:
Mailing address:
  • Phone: 717-514-7559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOC18148
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License NumberOC18148
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: