Provider Demographics
NPI:1942636840
Name:WALKER, LAURA BETH (BCBA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH
Last Name:WALKER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:BETH
Other - Last Name:HARP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:9929 E 126TH ST
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-9404
Mailing Address - Country:US
Mailing Address - Phone:317-436-8961
Mailing Address - Fax:317-991-1593
Practice Address - Street 1:9929 E 126TH ST
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-9404
Practice Address - Country:US
Practice Address - Phone:317-436-8961
Practice Address - Fax:317-991-1593
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0-12-5075103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst