Individual
MARK STEVEN WALKUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
390 RIVER ST, HCRS, SPRINGFIELD, VT 05156-2226
(207) 282-1500
(207) 282-2581
Mailing address
390 RIVER ST, HCRS, SPRINGFIELD, VT 05156-2226
(802) 886-4500
(802) 886-4520
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0089939
VT
1041C0700X
Clinical Social Worker
LC6445
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272600099
—
ME
Enumeration date
08/09/2006
Last updated
05/10/2013
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