Individual
AUTUMN WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2248 S 102ND ST. #155, WEST ALLIS, WI 53227-2147
(414) 541-5100
(844) 515-9455
Mailing address
3900 W BROWN DEER RD, SUITE 200, BROWN DEER, WI 53209-1220
(414) 540-2170
(414) 540-2171
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1631-226
WI
101YP2500X
Professional Counselor
Primary
5681-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100027688
—
WI
Enumeration date
01/15/2013
Last updated
10/06/2021
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