Basic Information
Provider Information
NPI: 1780669424
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WALKER
FirstName: ANN
MiddleName: DEBORAH
NamePrefix: MS.
NameSuffix:  
Credential: L.C.S.W.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 450 GIBNER RD
Address2: DUNHAM ARMY HEALTH CLINIC
City: CARLISLE BARRACKS
State: PA
PostalCode: 170135003
CountryCode: US
TelephoneNumber: 7172453041
FaxNumber: 7172453815
Practice Location
Address1: 450 GIBNER RD
Address2: DUNHAM ARMY HEALTH CLINIC
City: CARLISLE BARRACKS
State: PA
PostalCode: 170135003
CountryCode: US
TelephoneNumber: 7172453041
FaxNumber: 7172453815
Other Information
ProviderEnumerationDate: 12/14/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XCW013569PAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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