MEDICARE: WALKER CONSULTING & PSYCHOLOGICAL SERVICES

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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1508498395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALKER CONSULTING & PSYCHOLOGICAL SERVICES

Provider Business Mailing Address
First Line	:	4375 COBB PKWY SE STE 121
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-5537
Country	:	US
Telephone Number	:	678-383-6353
Fax Number	:

Provider Business Practice Location Address
First Line	:	4375 COBB PKWY SE STE 121
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-5537
Country	:	US
Telephone Number	:	678-383-6353
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PSYCHOLOGIST
Name	:	ERICA WALKER
Credential	:
Telephone Number	:	678-383-6353

Provider Enumeration Date	:	02/10/2020
Last Update Date	:	02/10/2020

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