MEDICARE: MRS. DAWN WILLENA 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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1851540207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAWN WILLENA WALKER

Provider Business Mailing Address
First Line	:	PO BOX 364504
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89036
Country	:	US
Telephone Number	:	702-927-6790
Fax Number	:

Provider Business Practice Location Address
First Line	:	2475 W CHEYENNE AVE
Second Line	:	SUITE 170
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-4327
Country	:	US
Telephone Number	:	702-927-6790
Fax Number	:

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

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	04/19/2023

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