Provider Demographics
NPI:1548877830
Name:WALKER, ALEXIS RAE (LAPC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:RAE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:RAE
Other - Last Name:O'HALLORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAPC
Mailing Address - Street 1:PO BOX 9859
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58106-9859
Mailing Address - Country:US
Mailing Address - Phone:701-746-4584
Mailing Address - Fax:651-925-0057
Practice Address - Street 1:1726 S WASHINGTON ST STE 33A
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6395
Practice Address - Country:US
Practice Address - Phone:701-746-4584
Practice Address - Fax:651-925-0057
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1088-10-1-20A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional