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General NPI Number Information
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NPI Number | 1932137056
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Entity Type | Individual
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Provider Name | MARY JEANNE WALKER M.S.CCC-A
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Gender | Female
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 01/15/2009
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Provider Practice Location Address
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Address Line | 500 CONGRESS ST 2J
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City | QUINCY
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State | MA
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Zip | 02169-0908
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Country | US
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Telephone | 617-479-7503
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 406153
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City | ATLANTA
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State | GA
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Zip | 30384-6153
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Country | US
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Telephone |
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Fax |
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 416
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License Number State | MA
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