Provider Demographics
NPI:1801386347
Name:WALKER, SUSAN MILLIGAN
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MILLIGAN
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 CONCOURSE BLVD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5779
Mailing Address - Country:US
Mailing Address - Phone:804-346-1300
Mailing Address - Fax:
Practice Address - Street 1:600 CONCOURSE BLVD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-5779
Practice Address - Country:US
Practice Address - Phone:804-346-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007674235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist