Provider Demographics
NPI:1669088357
Name:WALKER, ZACHARY (BCABA)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 MEADOW SAGE LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4928
Mailing Address - Country:US
Mailing Address - Phone:757-510-1272
Mailing Address - Fax:
Practice Address - Street 1:5151 BONNEY RD STE 107
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-4384
Practice Address - Country:US
Practice Address - Phone:757-222-1315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000502103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst