Provider Demographics
NPI:1194885160
Name:WALKER, JUDITH L (MED)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:L
Last Name:WALKER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 N COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130
Mailing Address - Country:US
Mailing Address - Phone:740-654-2775
Mailing Address - Fax:740-654-2776
Practice Address - Street 1:843 N COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130
Practice Address - Country:US
Practice Address - Phone:740-654-2775
Practice Address - Fax:740-654-2776
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE001499101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health