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General NPI Number Information
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NPI Number | 1568793032
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Entity Type | Individual
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Provider Name | MARY-EILEEN WALKER MS
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Gender | Female
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Dates
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Enumeration Date | 01/23/2010
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Last Update Date | 03/15/2011
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Provider Practice Location Address
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Address Line | 1881 NE 26TH ST SUITE 70
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City | WILTON MANORS
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State | FL
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Zip | 33305-1416
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Country | US
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Telephone | 954-463-2723
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Fax | 954-463-1687
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Provider Business Mailing Address
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Address Line | 1881 NE 26TH ST SUITE 70
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City | WILTON MANORS
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State | FL
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Zip | 33305
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Country | US
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Telephone | 954-463-2723
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Fax | 954-463-1687
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH1622
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT1260
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License Number State | FL
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