Provider Demographics
NPI:1194025841
Name:WALKER, AMBER C (BCBA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:C
Last Name:WALKER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 SLOCUM RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:CT
Mailing Address - Zip Code:06248-1438
Mailing Address - Country:US
Mailing Address - Phone:860-228-2894
Mailing Address - Fax:
Practice Address - Street 1:15 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:EAST GRANBY
Practice Address - State:CT
Practice Address - Zip Code:06026-9770
Practice Address - Country:US
Practice Address - Phone:860-413-9538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-06-3038103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst