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General NPI Number Information
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NPI Number | 1780814699
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Entity Type | Individual
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Provider Name | ROBERT DOUGLAS WALKER LICDC
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Gender | Male
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 07/27/2009
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Provider Practice Location Address
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Address Line | 20525 CENTER RIDGE RD SUITE 608
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City | ROCKY RIVER
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State | OH
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Zip | 44116-3437
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Country | US
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Telephone | 440-331-3832
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Fax | 216-671-9873
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Provider Business Mailing Address
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Address Line | 3228 W 114TH ST
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City | CLEVELAND
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State | OH
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Zip | 44111-2734
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Country | US
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Telephone | 216-337-6859
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Fax | 216-671-9873
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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 | 913018
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License Number State | OH
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