Individual
MRS. BERNICE L WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2449 BRACKNELL FOREST TRL, TAVARES, FL 32778-5706
(352) 434-8454
Mailing address
2449 BRACKNELL FOREST TRL, TAVARES, FL 32778-5706
(352) 434-8454
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13351135Z
—
FL
Enumeration date
10/09/2019
Last updated
10/09/2019
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