Provider Demographics
NPI:1598040826
Name:WALKER, WENDY R (MSW)
Entity type:Individual
Prefix:MS
First Name:WENDY
Middle Name:R
Last Name:WALKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 E 72ND ST STE 1C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4574
Mailing Address - Country:US
Mailing Address - Phone:212-744-4165
Mailing Address - Fax:
Practice Address - Street 1:242 E 72ND ST STE 1C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4574
Practice Address - Country:US
Practice Address - Phone:212-744-4165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025561-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst