Provider Demographics
NPI:1679310544
Name:GRANDERSON WALKER, SONYA RENEE
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:RENEE
Last Name:GRANDERSON WALKER
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 1:1444 KOHR PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-2261
Mailing Address - Country:US
Mailing Address - Phone:614-556-0883
Mailing Address - Fax:
Practice Address - Street 1:1444 KOHR PL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2261
Practice Address - Country:US
Practice Address - Phone:614-556-0883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care