MEDICARE: COURTNEY WALKER

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	376J00000X	Homemaker
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1174229140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY WALKER

Provider Business Mailing Address
First Line	:	2412 PINEGROVE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45449-3343
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2412 PINEGROVE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45449-3343
Country	:	US
Telephone Number	:	937-952-8922
Fax Number	:

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

Provider Enumeration Date	:	02/01/2023
Last Update Date	:	01/22/2024

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Directions to “ COURTNEY WALKER ” Practice Location

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