Provider Demographics
NPI:1275842049
Name:WALKER, KELLEE L (MA, LPC)
Entity Type:Individual
Prefix:
First Name:KELLEE
Middle Name:L
Last Name:WALKER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 WEST DALLAS
Mailing Address - Street 2:SUITE 160
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:812 WEST DALLAS
Practice Address - Street 2:SUITE 160
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301
Practice Address - Country:US
Practice Address - Phone:936-788-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional