Provider Demographics
NPI:1891004156
Name:WALKER, ALICIA M (MA)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:M
Last Name:WALKER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:M
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 HOSPITAL PLZ
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-9316
Mailing Address - Country:US
Mailing Address - Phone:304-623-5661
Mailing Address - Fax:
Practice Address - Street 1:40 COMMERCE DR STE B
Practice Address - Street 2:
Practice Address - City:WESTOVER
Practice Address - State:WV
Practice Address - Zip Code:26501-3952
Practice Address - Country:US
Practice Address - Phone:304-241-1708
Practice Address - Fax:304-381-2054
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1157103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist