Provider Demographics
NPI:1508440702
Name:WALK, JANET KAY
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:KAY
Last Name:WALK
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 1:851 E 5TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63090-3129
Mailing Address - Country:US
Mailing Address - Phone:636-239-8585
Mailing Address - Fax:636-239-8553
Practice Address - Street 1:851 E 5TH ST STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-3129
Practice Address - Country:US
Practice Address - Phone:636-239-8585
Practice Address - Fax:636-239-8553
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20180197911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical