Provider Demographics
NPI:1891889465
Name:WALKER, SALLY LOUISE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:SALLY
Middle Name:LOUISE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 MORNING EDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613
Mailing Address - Country:US
Mailing Address - Phone:919-575-2615
Mailing Address - Fax:919-575-2139
Practice Address - Street 1:1003 12 STREET
Practice Address - Street 2:
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509
Practice Address - Country:US
Practice Address - Phone:919-575-2615
Practice Address - Fax:919-575-2139
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital