Provider Demographics
NPI:1841706215
Name:WALKER, CAROLYN LENICE
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:LENICE
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7162 READING RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-3838
Mailing Address - Country:US
Mailing Address - Phone:513-961-5900
Mailing Address - Fax:
Practice Address - Street 1:2627 PARK AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1476
Practice Address - Country:US
Practice Address - Phone:513-363-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician