Provider Demographics
NPI:1578253464
Name:WALKER, AMY RENA
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:RENA
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:RENA
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:394 COUNTY ROAD 1544
Mailing Address - Street 2:
Mailing Address - City:EVA
Mailing Address - State:AL
Mailing Address - Zip Code:35621-6028
Mailing Address - Country:US
Mailing Address - Phone:205-915-3085
Mailing Address - Fax:
Practice Address - Street 1:394 COUNTY ROAD 1544
Practice Address - Street 2:
Practice Address - City:EVA
Practice Address - State:AL
Practice Address - Zip Code:35621-6028
Practice Address - Country:US
Practice Address - Phone:205-915-3085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker