Provider Demographics
NPI:1841669082
Name:WALKER, JODI CHRISTINE (LCMHC)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:CHRISTINE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 HERITAGE PARK BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5679
Mailing Address - Country:US
Mailing Address - Phone:801-784-7356
Mailing Address - Fax:801-210-5275
Practice Address - Street 1:476 HERITAGE PARK BLVD STE 220
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5679
Practice Address - Country:US
Practice Address - Phone:801-784-7356
Practice Address - Fax:801-210-5275
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
UT9657930-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health