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Individual

MS. MARI SULLIVAN WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A. LICENSED PSYCHO

Contact information

Practice address
102 HOWARD AVE, MULLENS, WV 25882-1419
(304) 294-5353
(304) 294-8627
Mailing address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 425-9541
(304) 487-6199

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
203
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005489001
WV
05
0005489002
WV
Enumeration date
09/15/2006
Last updated
01/11/2013
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