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General NPI Number Information
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NPI Number | 1477366961
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Entity Type | Individual
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Provider Name | MARSHA DURRANT WALKER ED.S
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Gender | Female
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 2720 CALIFORNIA RD
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City | ELKHART
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State | IN
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Zip | 46514-1220
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Country | US
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Telephone | 574-262-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 3502 N MAIN ST APT 6
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City | MISHAWAKA
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State | IN
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Zip | 46545-3156
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Country | US
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Telephone | 574-292-9350
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 10241166
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License Number State | IN
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