Provider Demographics
NPI:1841456241
Name:WALKER, MERILEE (COTA/L)
Entity type:Individual
Prefix:
First Name:MERILEE
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 9TH ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-4037
Mailing Address - Country:US
Mailing Address - Phone:505-426-7466
Mailing Address - Fax:505-425-7196
Practice Address - Street 1:1118 9TH ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4037
Practice Address - Country:US
Practice Address - Phone:505-426-7466
Practice Address - Fax:505-425-7196
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2260224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant