Provider Demographics
NPI:1730483231
Name:WALKER, NANCY DIONNE
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:DIONNE
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:PROF
Other - First Name:NANCY
Other - Middle Name:DIONNE
Other - Last Name:WALKER-MCCAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:128 E BOSTON AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44507-1743
Mailing Address - Country:US
Mailing Address - Phone:330-881-9675
Mailing Address - Fax:
Practice Address - Street 1:4505 LOGAN WAY
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-3311
Practice Address - Country:US
Practice Address - Phone:330-259-3664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1700462101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health