Provider Demographics
NPI:1265527907
Name:WALKER, DEBORAH Y R (SW)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:Y R
Last Name:WALKER
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26234 DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-3254
Mailing Address - Country:US
Mailing Address - Phone:313-378-1768
Mailing Address - Fax:313-427-3607
Practice Address - Street 1:26234 DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-3254
Practice Address - Country:US
Practice Address - Phone:313-378-1768
Practice Address - Fax:313-427-3607
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801011537104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6802011537OtherSTATE OF MICHIGAN