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General NPI Number Information
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NPI Number | 1760928402
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Entity Type | Organization
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Legal Business Name | MARY WALKER & ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/18/2017
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 2312 WILTON DR SUITE 28
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City | WILTON MANORS
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State | FL
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Zip | 33305-1249
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Country | US
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Telephone | 954-536-7735
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Fax |
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Provider Business Mailing Address
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Address Line | 8228 NW 8TH CT
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City | PLANTATION
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State | FL
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Zip | 33324-1204
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Country | US
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Telephone | 954-536-7735
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. MARY WALKER
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Credential | MS, LMHC, LMFT
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Telephone | 954-536-7735
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #3
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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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