Basic Information
| Provider Information | |||||||||
| NPI: | 1003294836 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WALKER-NOVI | ||||||||
| FirstName: | DANI | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2577 NE COURTNEY DR | ||||||||
| Address2: | |||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977017752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7500541322 | ||||||||
| FaxNumber: | 5413227565 | ||||||||
| Practice Location | |||||||||
| Address1: | 1128 NW HARRIMAN ST | ||||||||
| Address2: | |||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977031947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413227662 | ||||||||
| FaxNumber: | 5413304630 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2015 | ||||||||
| LastUpdateDate: | 04/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | LMSW-33926 | ID | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | L8043 | OR | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.