Healthcare Provider Details

I. General information

NPI: 1316119720
Provider Name (Legal Business Name): CHRISTIE MARIE PARKER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 05/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6250 US 62
HILLSBORO OH
45133-7582
US

IV. Provider business mailing address

6187 MILLER LN
HILLSBORO OH
45133-9610
US

V. Phone/Fax

Practice location:
  • Phone: 937-404-1550
  • Fax:
Mailing address:
  • Phone: 937-402-9691
  • Fax: 937-393-6829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.0500563
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.006488
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: