Provider Demographics
NPI:1326407644
Name:WALKER, MARY (LPC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARYANNE
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:700 ROCKMEAD DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2103
Mailing Address - Country:US
Mailing Address - Phone:281-900-6918
Mailing Address - Fax:
Practice Address - Street 1:700 ROCKMEAD DR
Practice Address - Street 2:SUITE 205
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2103
Practice Address - Country:US
Practice Address - Phone:281-900-6918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71329101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health