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1366203077
SAMUEL WALKER
GULFPORT, MS
NPI
1366203077
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
(Licence: MS 4138)
Enumeration Date
2024-01-19
Last Update Date
2024-01-19
Business Address
SAMUEL WALKER PCCSSS
1600 BROAD AVE
GULFPORT, MS 39501-3603
Phone number: 228-213-5888
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Mailing Address
SAMUEL WALKER PCCSSS
PO BOX 18679
HATTIESBURG, MS 39404-8679
Phone number: 601-705-1901
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