Healthcare Provider Details

I. General information

NPI: 1285288548
Provider Name (Legal Business Name): HALEY PARKER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 S CLAIRBORNE RD
OLATHE KS
66062-2138
US

IV. Provider business mailing address

207 MORNINGVIEW DR
HARRISONVILLE MO
64701-3969
US

V. Phone/Fax

Practice location:
  • Phone: 913-617-0492
  • Fax: 913-300-9675
Mailing address:
  • Phone: 816-289-3174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-54528
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: