Provider Demographics
NPI:1417751173
Name:WALKER, ELIZABETH PHIPPS
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:PHIPPS
Last Name:WALKER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N17W24222 RIVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53188-8319
Mailing Address - Country:US
Mailing Address - Phone:262-793-0961
Mailing Address - Fax:262-264-1032
Practice Address - Street 1:N17W24222 RIVERWOOD DR
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53188
Practice Address - Country:US
Practice Address - Phone:262-793-0961
Practice Address - Fax:262-264-1032
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist