Basic Information
| Provider Information | |||||||||
| NPI: | 1912215898 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | DANASHIA | ||||||||
| MiddleName: | A | ||||||||
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| OtherLastName: | WALKER | ||||||||
| OtherFirstName: | DANASHIA | ||||||||
| OtherMiddleName: | A | ||||||||
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| OtherCredential: | P-LCSW | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1845 MISSION OAKS ST | ||||||||
| Address2: | |||||||||
| City: | KANNAPOLIS | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280837810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047870428 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1190 W. ROOSEVELT BLVD | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281102818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042966200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2010 | ||||||||
| LastUpdateDate: | 07/27/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 2561 | NC | N | Behavioral Health & Social Service Providers | Counselor | 1041C0700X | P006669 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.