Provider Demographics
NPI:1053703322
Name:WALWYN-DUQUESNAY, TIKISHA
Entity type:Individual
Prefix:
First Name:TIKISHA
Middle Name:
Last Name:WALWYN-DUQUESNAY
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 1:6671 SOUTHWEST FREEWAY HOUSTON
Mailing Address - Street 2:SUITE 700
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:832-617-0338
Mailing Address - Fax:
Practice Address - Street 1:12531 W HWY 71
Practice Address - Street 2:P3007
Practice Address - City:BEE CAVE
Practice Address - State:TX
Practice Address - Zip Code:78738-6640
Practice Address - Country:US
Practice Address - Phone:713-979-6746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional