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NPI 1306014766

NPI 1306014766 : GUY WALKER JR. LPC : JACKSONVILLE, AL

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General NPI Number Information
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    NPI Number           |    1306014766
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    Entity Type          |    Individual 
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    Provider Name        |    GUY WALKER JR. LPC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/19/2008
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    Last Update Date     |    02/19/2008
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Provider Practice Location Address
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    Address Line         |    614 PELHAM RD S 
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    City                 |    JACKSONVILLE
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    State                |    AL
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    Zip                  |    36265-2732
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    Country              |    US
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    Telephone            |    256-435-5502
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    Fax                  |    256-435-5797
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Provider Business Mailing Address
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    Address Line         |    614 PELHAM RD S 
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    City                 |    JACKSONVILLE
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    State                |    AL
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    Zip                  |    36265-2732
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    Country              |    US
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    Telephone            |    256-435-5502
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    Fax                  |    256-435-5797
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    966
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    License Number State |    AL
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