Provider Demographics
NPI:1336419563
Name:WALKER, O'NEAL ALFRED
Entity Type:Individual
Prefix:DR
First Name:O'NEAL
Middle Name:ALFRED
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19215 WHEATFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-1733
Mailing Address - Country:US
Mailing Address - Phone:240-426-1600
Mailing Address - Fax:301-972-1813
Practice Address - Street 1:6237 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3906
Practice Address - Country:US
Practice Address - Phone:240-426-5859
Practice Address - Fax:301-972-1318
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04000103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical