Provider Demographics
NPI:1851979884
Name:WALKER, STEPHEN LEE
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:LEE
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 EYDE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5431
Mailing Address - Country:US
Mailing Address - Phone:517-512-4320
Mailing Address - Fax:
Practice Address - Street 1:2875 EYDE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5431
Practice Address - Country:US
Practice Address - Phone:517-512-4320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician