Healthcare Provider Details

I. General information

NPI: 1952257131
Provider Name (Legal Business Name): JUWONNA WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10125 W COLD SPRING RD APT 107
GREENFIELD WI
53228-2627
US

IV. Provider business mailing address

10125 W COLD SPRING RD APT 107
GREENFIELD WI
53228-2627
US

V. Phone/Fax

Practice location:
  • Phone: 608-960-6280
  • Fax: 608-960-6280
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: