Individual
TAMMY T WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6858 SWINNEA RD BLDG 6B, SOUTHAVEN, MS 38671-9493
(626) 426-6136
Mailing address
6858 SWINNEA RD BLDG 6B, SOUTHAVEN, MS 38671-9493
(626) 426-6136
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
22-237467
MS
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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