Provider Demographics
NPI:1952070534
Name:WALKER, CHRISTINA ANN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:ANN
Last Name:WALKER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4419 NEWBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83607-4507
Mailing Address - Country:US
Mailing Address - Phone:308-340-2600
Mailing Address - Fax:
Practice Address - Street 1:1919 W STATE ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-3958
Practice Address - Country:US
Practice Address - Phone:208-813-6246
Practice Address - Fax:208-813-6248
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-37371104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker