Provider Demographics
NPI:1205164001
Name:WALKER, PATRICIA BOUIER (CLINICAL SOCIAL WORK)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:BOUIER
Last Name:WALKER
Suffix:
Gender:F
Credentials:CLINICAL SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5936 YORKSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-2041
Mailing Address - Country:US
Mailing Address - Phone:313-282-0989
Mailing Address - Fax:
Practice Address - Street 1:5936 YORKSHIRE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-2041
Practice Address - Country:US
Practice Address - Phone:313-282-0989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801080954172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker