Provider Demographics
NPI:1578325098
Name:WALKER, CAMERON (CIT)
Entity Type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:CIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 MOSSY BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-7777
Mailing Address - Country:US
Mailing Address - Phone:864-590-3058
Mailing Address - Fax:
Practice Address - Street 1:4411 SUWANEE DAM RD STE 310
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-8702
Practice Address - Country:US
Practice Address - Phone:404-465-3764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health