Individual
TERENCE TARELL WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
STUDENT
Contact information
Practice address
9610 N 52ND LN, GLENDALE, AZ 85302-3416
(773) 600-4302
Mailing address
9610 N 52ND LN, GLENDALE, AZ 85302-3416
(773) 600-4302
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/15/2021
Last updated
12/15/2021
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