Individual
JAN MAEDGEN WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2010 SYBIL LN, TYLER, TX 75703-1818
(903) 596-8118
(903) 596-8125
Mailing address
2010 SYBIL LN, TYLER, TX 75703-1818
(903) 596-8118
(903) 596-8125
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
12783
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152550301
—
TX
Enumeration date
08/04/2006
Last updated
07/08/2007
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