Individual
MRS. MICHELE L WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2402 NORTH TIFT AVE., STE. 102 SOUTH GEORGIA PSYCHIATRIC AND COUNSELING CENTE, TIFTON, GA 31794
(229) 387-8878
(229) 387-8881
Mailing address
2402 NORTH TIFT AVE., STE. 102 SOUTH GEORGIA PSYCHIATRIC AND COUNSELING CENTE, TIFTON, GA 31794
(229) 387-8878
(229) 387-8881
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003267
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
348879000
MAGELLAN HEALTH SERVICES
GA
01
—
52072002-01
BLUE CROSS/BLUE SHEILD
GA
05
—
764550927A, B, C, D
—
GA
Enumeration date
07/12/2006
Last updated
03/09/2009
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