Provider Demographics
NPI:1811312556
Name:WALKER, STEPHANIE ELAYNE (OTR/L)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ELAYNE
Last Name:WALKER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ELAYNE
Other - Last Name:MEEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2075 E WEST MAPLE RD
Mailing Address - Street 2:SUITE B-204
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48390
Mailing Address - Country:US
Mailing Address - Phone:248-926-0909
Mailing Address - Fax:
Practice Address - Street 1:2075 E WEST MAPLE RD
Practice Address - Street 2:SUITE B-204
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390
Practice Address - Country:US
Practice Address - Phone:248-926-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201008721174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist