Provider Demographics
NPI:1124375837
Name:WALKER, NATACHA
Entity Type:Individual
Prefix:MS
First Name:NATACHA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3122
Mailing Address - Country:US
Mailing Address - Phone:321-722-5200
Mailing Address - Fax:321-953-7510
Practice Address - Street 1:4450 WEST EAU GALLIE BLVD
Practice Address - Street 2:200
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-9998
Practice Address - Country:US
Practice Address - Phone:321-726-2860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-13
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health