Provider Demographics
NPI:1760717730
Name:WALKER-SIMON, CLAUDETTE (BS)
Entity Type:Individual
Prefix:MRS
First Name:CLAUDETTE
Middle Name:
Last Name:WALKER-SIMON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MS
Other - First Name:CLAUDETTE
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:3910 W DARROW ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-6010
Mailing Address - Country:US
Mailing Address - Phone:602-237-4066
Mailing Address - Fax:602-237-4066
Practice Address - Street 1:3910 W DARROW ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-6010
Practice Address - Country:US
Practice Address - Phone:602-237-4066
Practice Address - Fax:602-237-4066
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH3417101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)