Provider Demographics
NPI:1447305040
Name:WALKER, CHRISTOPHER MARTIN (MA-CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MARTIN
Last Name:WALKER
Suffix:
Gender:M
Credentials:MA-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2512 ALABASTER AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32833-4309
Mailing Address - Country:US
Mailing Address - Phone:321-229-9806
Mailing Address - Fax:
Practice Address - Street 1:4401 E COLONIAL DR
Practice Address - Street 2:SUITE 107
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5200
Practice Address - Country:US
Practice Address - Phone:407-898-5060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6577235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist