Provider Demographics
NPI:1356794739
Name:WALKER, KATIE MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:MARIE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3021 HARBOR LN N
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-5109
Mailing Address - Country:US
Mailing Address - Phone:763-559-1640
Mailing Address - Fax:763-559-1617
Practice Address - Street 1:3021 HARBOR LN N
Practice Address - Street 2:SUITE 206
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-5109
Practice Address - Country:US
Practice Address - Phone:763-559-1640
Practice Address - Fax:763-559-1617
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist