Provider Demographics
NPI:1477742146
Name:FIELDS-WALKER, DOROTHY ANNETTE (MSW)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:ANNETTE
Last Name:FIELDS-WALKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:ANNETTE
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2615 MIDWAY BRANCH DR
Mailing Address - Street 2:202
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-2352
Mailing Address - Country:US
Mailing Address - Phone:443-303-9167
Mailing Address - Fax:410-305-8439
Practice Address - Street 1:2615 MIDWAY BRANCH DR
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-2352
Practice Address - Country:US
Practice Address - Phone:443-303-9167
Practice Address - Fax:410-305-8439
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-18
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3031401041C0700X
MD096511041C0700X
NCC0054621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical