Provider Demographics
NPI:1699045658
Name:WALKER, PATRICIA SUZANNE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:SUZANNE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 15TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3212
Mailing Address - Country:US
Mailing Address - Phone:908-209-1760
Mailing Address - Fax:
Practice Address - Street 1:935 15TH ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3212
Practice Address - Country:US
Practice Address - Phone:908-209-1760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC000076235Z00000X
VA2202006539235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist