Provider Demographics
NPI:1275941759
Name:WALKER, DANIEL RICHARD (CMHC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RICHARD
Last Name:WALKER
Suffix:
Gender:M
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 N 1330 W
Mailing Address - Street 2:SUITE A1
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-5111
Mailing Address - Country:US
Mailing Address - Phone:801-471-5964
Mailing Address - Fax:
Practice Address - Street 1:1060 RUSSELL RD
Practice Address - Street 2:
Practice Address - City:EAGLE MOUNTAIN
Practice Address - State:UT
Practice Address - Zip Code:84005-4243
Practice Address - Country:US
Practice Address - Phone:801-471-5964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT329356-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health