Provider Demographics
NPI:1568828523
Name:WALKER, DENISE
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:WALKER
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 1:1972 ARKANSAS RD UNIT 16
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-8615
Mailing Address - Country:US
Mailing Address - Phone:318-426-6574
Mailing Address - Fax:
Practice Address - Street 1:14673 MIDWAY RD STE 110
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3958
Practice Address - Country:US
Practice Address - Phone:214-865-8325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82346101YM0800X
LA1287101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health