Individual
CONSUELO DENISE WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2109 FAIRBURN RD STE A, DOUGLASVILLE, GA 30135-1037
(770) 726-7958
Mailing address
9244 CHARLTON PL, DOUGLASVILLE, GA 30135-7505
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
056419
GA
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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