Provider Demographics
NPI:1265669121
Name:WALKER, AMY SHERELL (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:SHERELL
Last Name:WALKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:CAMMACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:310 PALMSPRING DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2941
Mailing Address - Country:US
Mailing Address - Phone:301-963-1449
Mailing Address - Fax:
Practice Address - Street 1:310 PALMSPRING DR
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-2941
Practice Address - Country:US
Practice Address - Phone:301-963-1449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016856103T00000X
MD04833103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103T00000XBehavioral Health & Social Service ProvidersPsychologist