Individual
BRENDA WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3450 HIGHWAY 80 W, JACKSON, MS 39209-7201
(601) 321-2497
(601) 321-2476
Mailing address
3450 HIGHWAY 80 W, JACKSON, MS 39209-7201
(601) 321-2497
(601) 321-2476
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0053
MS
Other
Enumeration date
03/02/2012
Last updated
03/02/2012
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