Healthcare Provider Details

I. General information

NPI: 1891130043
Provider Name (Legal Business Name): MS. RANA WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2013
Last Update Date: 05/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 W MASTER ST APT. 310
PHILADELPHIA PA
19121-4427
US

IV. Provider business mailing address

3000 W MASTER ST APT. 310
PHILADELPHIA PA
19121-4427
US

V. Phone/Fax

Practice location:
  • Phone: 215-778-9895
  • Fax:
Mailing address:
  • Phone: 215-778-9895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: