Provider Demographics
NPI:1992462089
Name:WALKER, Q JULIAN
Entity type:Individual
Prefix:
First Name:Q
Middle Name:JULIAN
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43-45 BONN PL
Mailing Address - Street 2:
Mailing Address - City:WEEHAWKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07086
Mailing Address - Country:US
Mailing Address - Phone:212-300-5572
Mailing Address - Fax:
Practice Address - Street 1:65 BROADWAY STE 901
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-2535
Practice Address - Country:US
Practice Address - Phone:646-751-7908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor