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General NPI Number Information
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NPI Number | 1407337975
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Entity Type | Individual
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Provider Name | SHAWN ENNYECE WALKER
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Gender | Female
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Dates
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Enumeration Date | 08/23/2018
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 2930 CYPRESS GROVE MEADOW DR
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City | HOUSTON
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State | TX
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Zip | 77014-1574
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Country | US
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Telephone | 832-855-3362
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Fax |
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Provider Business Mailing Address
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Address Line | 2403 GIANNA WAY
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City | HOUSTON
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State | TX
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Zip | 77073-6801
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Country | US
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Telephone | 832-275-1827
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Fax |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 212284
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License Number State | TX
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