Provider Demographics
NPI:1922485424
Name:WALKER, KATINA (LMFT)
Entity Type:Individual
Prefix:
First Name:KATINA
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4152 W GOLDMINE MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-3727
Mailing Address - Country:US
Mailing Address - Phone:313-204-5588
Mailing Address - Fax:
Practice Address - Street 1:9440 E IRONWOOD SQUARE DR STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4569
Practice Address - Country:US
Practice Address - Phone:480-750-0095
Practice Address - Fax:480-750-0097
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-15269106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist