Provider Demographics
NPI:1427688118
Name:WALKER, DEANNA (MOTR/L)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:853 UNIVERSITY BLVD APT 101
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3084
Mailing Address - Country:US
Mailing Address - Phone:561-797-9534
Mailing Address - Fax:
Practice Address - Street 1:853 UNIVERSITY BLVD APT 101
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3084
Practice Address - Country:US
Practice Address - Phone:561-797-9534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XP0200X
FL20579225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics