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General NPI Number Information
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NPI Number | 1659725307
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Entity Type | Individual
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Provider Name | WAYNE SCOTT WALKER
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Gender | Male
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 6500 CANYON DR
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City | AMARILLO
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State | TX
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Zip | 79109-7030
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Country | US
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Telephone | 806-452-8006
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Fax | 806-452-8007
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Provider Business Mailing Address
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Address Line | PO BOX 667
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City | CANYON
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State | TX
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Zip | 79015-0667
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Country | US
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Telephone | 806-452-8006
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Fax | 806-452-8007
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 11978
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License Number State | TX
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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 | 202084
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License Number State | TX
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