Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | ||
N | 224Z00000X | Occupational Therapy Assistant | LA60164024 | WA |
NPI | 1255668406 |
---|---|
Provider Name | Linda Walton |
First Address | Fairburn, GA 30213-3132 |
Second Address | Fairburn, GA 30213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2009 |
Last Update Date | 04/11/2019 |