Provider Demographics
NPI:1477288058
Name:WALLS, COURTNEY DENISE (MSW)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:DENISE
Last Name:WALLS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:DENISE
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:107 RAND CIR
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-4605
Mailing Address - Country:US
Mailing Address - Phone:865-661-8039
Mailing Address - Fax:
Practice Address - Street 1:100 ADAMS LN
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-4909
Practice Address - Country:US
Practice Address - Phone:865-483-7743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker