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General NPI Number Information
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NPI Number | 1437667235
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Entity Type | Individual
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Provider Name | LEISA WALKER LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/15/2018
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 2 BENNINGTON PL
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City | PISCATAWAY
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State | NJ
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Zip | 08854-5701
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Country | US
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Telephone | 732-347-6441
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8391
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City | PISCATAWAY
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State | NJ
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Zip | 08855-8004
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Country | US
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Telephone | 732-309-1679
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05756000
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License Number State | NJ
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