Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003055393 |
---|---|
Provider Name | Dr. Amanda Lee Walker |
First Address | New Bedford, MA 02740-6728 |
Second Address | New Bedford, MA 02740-2766 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2009 |
Last Update Date | 11/02/2009 |