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NPI Code Detail

MEDICARE: AMBER WALKER

MEDICARE: AMBER 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
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000OTHERN/A

General Provider Information

NPI Number : 1851991459
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER WALKER
Provider Business Mailing Address
First Line : 9017 LARRIMORE LN
Second Line :
City : BELEWS CREEK
State : NC
Zip : 27009-9112
Country : US
Telephone Number : 336-455-1863
Fax Number :
Provider Business Practice Location Address
First Line : 770 PARK CENTRE DR
Second Line :
City : KERNERSVILLE
State : NC
Zip : 27284-3598
Country : US
Telephone Number : 704-780-4271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2020
Last Update Date : 11/01/2020

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1013523463 — MRS. LORI H NIEBAUER
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Practice Fax:
1750982641 — MR. MAURICE ANTONIO BROWN
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Directions to “ AMBER WALKER ” Practice Location

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