Provider Demographics
NPI:1992468284
Name:WALK, NAOMI N (MOT, OTR)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:N
Last Name:WALK
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 N JUNIATA ST
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-1455
Mailing Address - Country:US
Mailing Address - Phone:814-317-5507
Mailing Address - Fax:814-317-5522
Practice Address - Street 1:721 N JUNIATA ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-1455
Practice Address - Country:US
Practice Address - Phone:814-317-5507
Practice Address - Fax:814-317-5522
Is Sole Proprietor?:No
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018052225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist