Provider Demographics
NPI:1285211425
Name:WALKER, CAITLIN ELYSA
Entity Type:Individual
Prefix:MS
First Name:CAITLIN
Middle Name:ELYSA
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 2ND AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-2900
Mailing Address - Country:US
Mailing Address - Phone:706-329-3041
Mailing Address - Fax:
Practice Address - Street 1:6100 VETERANS PKWY STE 11
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-3514
Practice Address - Country:US
Practice Address - Phone:706-329-3041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician