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Individual

MRS. JENNIFER COTMAN WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUD

Contact information

Practice address
3017 13TH ST, GULFPORT, MS 39501-1833
(228) 863-6617
(228) 863-1747
Mailing address
3017 13TH ST, GULFPORT, MS 39501-1833
(228) 863-6617
(228) 863-1747

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
607
CO
231H00000X
Audiologist
Primary
A3785
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025887900
NE
05
1043519523
SD
05
200750450A
KS
05
75180081
CO
05
WOJO1984
WY
Enumeration date
03/23/2011
Last updated
05/09/2017
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