Provider Demographics
NPI:1023622545
Name:WALKER, JULIETTE ELISE (MED, LBA, BCBA, BS)
Entity type:Individual
Prefix:
First Name:JULIETTE
Middle Name:ELISE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MED, LBA, BCBA, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 TEACHERS HOUSE RD NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-9852
Mailing Address - Country:US
Mailing Address - Phone:980-580-6088
Mailing Address - Fax:
Practice Address - Street 1:1875 TEACHERS HOUSE RD NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-9852
Practice Address - Country:US
Practice Address - Phone:980-580-6088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-21-54928103K00000X
TXRBT-20-1333012080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst