MEDICARE: JANA MICHELLE WALKER L.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	SW125177	PA

General Provider Information

NPI Number	:	1124303607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA MICHELLE WALKER L.S.W.

Provider Business Mailing Address
First Line	:	229 THORNTON RD
Second Line	:
City	:	THORNTON
State	:	PA
Zip	:	19373-1060
Country	:	US
Telephone Number	:	201-892-4270
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 UPLAND AVE
Second Line	:	STE #208 & 209
City	:	UPLAND
State	:	PA
Zip	:	19015-2434
Country	:	US
Telephone Number	:	201-892-4270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2011
Last Update Date	:	10/17/2011

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