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General NPI Number Information
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NPI Number | 1710363940
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Entity Type | Individual
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Provider Name | SPESHAL WALKER PH.D
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Gender | Female
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Dates
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Enumeration Date | 08/11/2015
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 1055 HOWELL MILL RD NW FL 8
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City | ATLANTA
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State | GA
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Zip | 30318-5557
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Country | US
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Telephone | 404-800-1998
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Fax | 404-393-0989
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Provider Business Mailing Address
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Address Line | 1700 NORTHSIDE DRIVE, STE A7, PMB 1704
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City | ATLANTA
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State | GA
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Zip | 30318-2695
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Country | US
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Telephone | 404-800-1998
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Fax | 404-393-0989
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY004282
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 021335
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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