1487889150 NPI number — MRS. VERONICA DANIELLE MOORE WALKER MA/CCC-SLP

Table of content: MRS. VERONICA DANIELLE MOORE WALKER MA/CCC-SLP (NPI 1487889150)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487889150 NPI number — MRS. VERONICA DANIELLE MOORE WALKER MA/CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALKER
Provider First Name:
VERONICA
Provider Middle Name:
DANIELLE MOORE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA/CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487889150
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
37477 CRESTVIEW AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRAIRIEVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70769-4172
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-673-2868
Provider Business Mailing Address Fax Number:
225-751-1033

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
37477 CRESTVIEW AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRAIRIEVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70769-4172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-673-2868
Provider Business Practice Location Address Fax Number:
225-751-1033
Provider Enumeration Date:
05/22/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  3612 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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