Provider Demographics
NPI:1790077592
Name:WALKER, EMILY NELL (MED)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:NELL
Last Name:WALKER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17103 PRESTON RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1332
Mailing Address - Country:US
Mailing Address - Phone:972-250-1700
Mailing Address - Fax:972-250-1701
Practice Address - Street 1:17103 PRESTON RD
Practice Address - Street 2:SUITE 250
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1332
Practice Address - Country:US
Practice Address - Phone:972-250-1700
Practice Address - Fax:972-250-1701
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65427101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional