1578991618 NPI number — DR. JUDY PERKINS WALKER PH.D., CCC-SLP

Table of content: DR. JUDY PERKINS WALKER PH.D., CCC-SLP (NPI 1578991618)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578991618 NPI number — DR. JUDY PERKINS WALKER PH.D., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALKER
Provider First Name:
JUDY
Provider Middle Name:
PERKINS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D., 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:
1578991618
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/29/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
336 DUNN HL
Provider Second Line Business Mailing Address:
UNIVERSITY OF MAINE CONLEY SPEECH, LANGUAGE AND HEARIN
Provider Business Mailing Address City Name:
ORONO
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04469-5724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-581-2006
Provider Business Mailing Address Fax Number:
207-581-2060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5724 DUN HALL RM 336
Provider Second Line Business Practice Location Address:
UNIVERSITY OF MAINE
Provider Business Practice Location Address City Name:
ORONO
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04469-5724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-581-2006
Provider Business Practice Location Address Fax Number:
207-581-2060
Provider Enumeration Date:
10/29/2013

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:  SP945 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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