Provider Demographics
NPI:1447672167
Name:WALKER-HORTON, KEYONNA
Entity type:Individual
Prefix:
First Name:KEYONNA
Middle Name:
Last Name:WALKER-HORTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3365 SHEEP CANYON ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-3580
Mailing Address - Country:US
Mailing Address - Phone:702-280-8708
Mailing Address - Fax:
Practice Address - Street 1:3365 SHEEP CANYON ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-3580
Practice Address - Country:US
Practice Address - Phone:702-280-8708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health