Provider Demographics
NPI:1699456152
Name:WALKER, JODY BETH (TCM)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:BETH
Last Name:WALKER
Suffix:
Gender:F
Credentials:TCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 ELMER WALKER RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40769-9136
Mailing Address - Country:US
Mailing Address - Phone:606-401-3600
Mailing Address - Fax:
Practice Address - Street 1:151 ELMER WALKER RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:KY
Practice Address - Zip Code:40769-9136
Practice Address - Country:US
Practice Address - Phone:606-401-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator