Provider Demographics
NPI:1245278837
Name:WALKER HARRIS, SAUNDRA (LCSW)
Entity type:Individual
Prefix:
First Name:SAUNDRA
Middle Name:
Last Name:WALKER HARRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 APOLLO DR
Mailing Address - Street 2:STE 391
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774
Mailing Address - Country:US
Mailing Address - Phone:301-583-1181
Mailing Address - Fax:301-583-1184
Practice Address - Street 1:9701 APOLLO DR
Practice Address - Street 2:STE 391
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774
Practice Address - Country:US
Practice Address - Phone:301-583-1181
Practice Address - Fax:301-583-1184
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03452104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG02160S01Medicare PIN
MDG02160S01Medicare ID - Type UnspecifiedMEDICARE NUMBER