Provider Demographics
NPI:1952832743
Name:WALKER, COURTNEY (MS OT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:MS OT
Other - Prefix:
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Mailing Address - Street 1:1377 MOTOR PKWY STE 307
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:631-580-5200
Mailing Address - Fax:631-580-5222
Practice Address - Street 1:73 JEFFERSON CT
Practice Address - Street 2:
Practice Address - City:ZION CROSSROADS
Practice Address - State:VA
Practice Address - Zip Code:22942
Practice Address - Country:US
Practice Address - Phone:540-832-9012
Practice Address - Fax:540-832-9013
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119007286225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist