Provider Demographics
NPI:1124388699
Name:WALKER, MYTOI-A J (MED)
Entity Type:Individual
Prefix:MS
First Name:MYTOI-A
Middle Name:J
Last Name:WALKER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 ARCH ST FL 6
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-2835
Mailing Address - Country:US
Mailing Address - Phone:215-981-0088
Mailing Address - Fax:
Practice Address - Street 1:2302 EDGMONT AVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-5038
Practice Address - Country:US
Practice Address - Phone:267-428-3511
Practice Address - Fax:215-330-5293
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker