Provider Demographics
NPI:1093458325
Name:WALKER, ANGIE C (LMSW)
Entity Type:Individual
Prefix:MS
First Name:ANGIE
Middle Name:C
Last Name:WALKER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 SHANNON BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-2191
Mailing Address - Country:US
Mailing Address - Phone:302-981-3851
Mailing Address - Fax:
Practice Address - Street 1:153 SHANNON BLVD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-2191
Practice Address - Country:US
Practice Address - Phone:302-981-3851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0011050101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional