Walker, Autumn
Walker, Autumn is an sole proprietor health care provider with primary practice located at 2248 S 102Nd St. #155 , West Allis WI 53227-2147. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Walker, Autumn can be contacted via phone (414) 541-5100.Contact Information
Primary practice address
2248 S 102Nd St. #155
West Allis WI 53227-2147
Phone: (414) 541-5100
Fax: (844) 515-9455
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 1631-226 | Wisconsin |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 5681-125 | Wisconsin |
Profile Details
| NPI number | 1609113240 |
|---|---|
| LBN Legal business name | Walker, Autumn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 15th, 2013 |
| Last updated | Oct 6th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609113240 | NPPES |
| Wisconsin | MEDICAID | 100027688 |
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