Individual
JOHN WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ASAC
Contact information
Practice address
155 INDIAN HEAD RD, COMMACK, NY 11725-2212
(631) 543-6200
Mailing address
33 E BEECH ST, CENTRAL ISLIP, NY 11722-3140
(631) 543-6200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12833
NY
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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