Provider Demographics
NPI:1013201805
Name:WALKER, EDWYNA WARRIOR (BSED MED)
Entity Type:Individual
Prefix:MS
First Name:EDWYNA
Middle Name:WARRIOR
Last Name:WALKER
Suffix:
Gender:F
Credentials:BSED MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 N 7TH ST
Mailing Address - Street 2:APT. 1214
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-2565
Mailing Address - Country:US
Mailing Address - Phone:918-869-8200
Mailing Address - Fax:
Practice Address - Street 1:2700 N 7TH ST
Practice Address - Street 2:APT. 1214
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-2565
Practice Address - Country:US
Practice Address - Phone:918-869-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor