Individual
SUSAN ARLENE VANWALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ITDS
Contact information
Practice address
315 NE 10TH AVE, CRYSTAL RIVER, FL 34429-4456
(813) 403-1411
Mailing address
5568 WEST KEATING COURT, HOMOSASSA, FL 34448-1667
(813) 403-1411
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/22/2015
Last updated
07/28/2015
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