Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 3153 | NC |
NPI | 1093957664 |
---|---|
Provider Name | Dr. Jessica Ann Walker |
First Address | Salisbury, NC 28144 |
Second Address | Salisbury, NC 28144-2515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2009 |
Last Update Date | 26/03/2012 |