Provider Demographics
NPI:1750793402
Name:WALTON-BUFORD, SERIFATU TAMARA (LMFT-A)
Entity type:Individual
Prefix:MS
First Name:SERIFATU
Middle Name:TAMARA
Last Name:WALTON-BUFORD
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:SERIFATU
Other - Middle Name:TAMARA
Other - Last Name:WALTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT-A
Mailing Address - Street 1:513 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72114
Mailing Address - Country:US
Mailing Address - Phone:501-777-5969
Mailing Address - Fax:317-241-0201
Practice Address - Street 1:513 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114
Practice Address - Country:US
Practice Address - Phone:501-777-5969
Practice Address - Fax:317-241-0201
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN85000095A106H00000X
ARF1902001106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist