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Individual

SUSAN DENISE WALKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, MS, LPC, LMFT

Contact information

Practice address
322D N BLOOMINGTON ST, LOWELL, AR 72745-9136
(479) 366-7920
Mailing address
PO BOX 346, CAVE SPRINGS, AR 72718-0346
(479) 366-7920

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
P0403014
AR
106H00000X
Marriage & Family Therapist
Primary
M0501001
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5Y019
BLUE SHIELD PROVIDER #
AR
Enumeration date
06/14/2006
Last updated
09/10/2013
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