Provider Demographics
NPI:1700399151
Name:WALKER, LENA MARIE (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:LENA
Middle Name:MARIE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 COUNTY ROAD 259
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76446-5030
Mailing Address - Country:US
Mailing Address - Phone:254-485-8661
Mailing Address - Fax:
Practice Address - Street 1:2601 NW LOOP
Practice Address - Street 2:
Practice Address - City:STEPHENVILLE
Practice Address - State:TX
Practice Address - Zip Code:76401-1712
Practice Address - Country:US
Practice Address - Phone:254-968-4649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107684235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist