Provider Demographics
NPI:1053067223
Name:WALKER, REASHONDRA (LGSW)
Entity Type:Individual
Prefix:
First Name:REASHONDRA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 EQUITABLE DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3684
Mailing Address - Country:US
Mailing Address - Phone:952-395-6959
Mailing Address - Fax:
Practice Address - Street 1:7700 EQUITABLE DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3684
Practice Address - Country:US
Practice Address - Phone:932-395-6959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN275311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical