Provider Demographics
NPI:1306614144
Name:WALKER, SIERRA DAWN (TLMHC)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:DAWN
Last Name:WALKER
Suffix:
Gender:F
Credentials:TLMHC
Other - Prefix:
Other - First Name:SIERRA
Other - Middle Name:DAWN
Other - Last Name:ROE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:407 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALLERTON
Mailing Address - State:IA
Mailing Address - Zip Code:50008-9762
Mailing Address - Country:US
Mailing Address - Phone:641-856-9384
Mailing Address - Fax:
Practice Address - Street 1:221 E STATE ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-1813
Practice Address - Country:US
Practice Address - Phone:641-856-6471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA123602101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health