Provider Demographics
NPI:1093836140
Name:WALKER, AUDREY SORENSEN (MS, CCC, SLP)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:SORENSEN
Last Name:WALKER
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5171 S COTTONWOOD ST
Mailing Address - Street 2:SUITE 810
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5704
Mailing Address - Country:US
Mailing Address - Phone:801-507-7551
Mailing Address - Fax:
Practice Address - Street 1:8TH AVE C ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103
Practice Address - Country:US
Practice Address - Phone:801-408-5338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist