Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 000457 | CT |
NPI | 1033416508 |
---|---|
Provider Name | Dr. Kia Tiyanna Walker |
First Address | Bridgeport, CT 06604-5621 |
Second Address | New Haven, CT 06511-6443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2011 |
Last Update Date | 18/02/2011 |