Provider Demographics
NPI:1770772279
Name:WALKER, LATARSHA DORIS (MALCPC)
Entity type:Individual
Prefix:MRS
First Name:LATARSHA
Middle Name:DORIS
Last Name:WALKER
Suffix:
Gender:F
Credentials:MALCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7704 STARSHINE DR
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1895
Mailing Address - Country:US
Mailing Address - Phone:301-336-2452
Mailing Address - Fax:
Practice Address - Street 1:7704 STARSHINE DR
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-1895
Practice Address - Country:US
Practice Address - Phone:301-336-2452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1957101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional