Provider Demographics
NPI:1346865011
Name:WALKER, BRANDON JAMES (OTD)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:JAMES
Last Name:WALKER
Suffix:
Gender:M
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 WILKINSON ST APT 204
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-2361
Mailing Address - Country:US
Mailing Address - Phone:469-859-9092
Mailing Address - Fax:
Practice Address - Street 1:8300 EARHART BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-4428
Practice Address - Country:US
Practice Address - Phone:504-866-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA322204225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics