Provider Demographics
NPI:1932650579
Name:WALKER, NATRICE J (MED CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NATRICE
Middle Name:J
Last Name:WALKER
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 GLENDALE LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-5631
Mailing Address - Country:US
Mailing Address - Phone:229-310-9916
Mailing Address - Fax:
Practice Address - Street 1:809 GLENDALE LN
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-5631
Practice Address - Country:US
Practice Address - Phone:229-310-9916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP009458235Z00000X
FLSA17431235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist