Provider Demographics
NPI:1891073789
Name:WALKER, MARCIA LEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:LEE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:MARCIA
Other - Middle Name:LEE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:15119 VIMY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:AR
Mailing Address - Zip Code:72002-1541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1604 MERRILL DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-1818
Practice Address - Country:US
Practice Address - Phone:501-217-4995
Practice Address - Fax:501-217-9437
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006188235Z00000X
KY3916235Z00000X
TX105909235Z00000X
AR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist