Provider Demographics
NPI:1386136075
Name:WALKER, ANNA NEWTON (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:NEWTON
Last Name:WALKER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 BARTLETT DR
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30461-6899
Mailing Address - Country:US
Mailing Address - Phone:912-536-5112
Mailing Address - Fax:
Practice Address - Street 1:THE THERAPY SPOT
Practice Address - Street 2:508 GENTILLY ROAD
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458
Practice Address - Country:US
Practice Address - Phone:912-681-7768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP010567235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty