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NPI 1104127398

NPI 1104127398 : CK PARSON ENTERPRISES : MOORE, OK

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General NPI Number Information
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    NPI Number           |    1104127398
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    Entity Type          |    Organization 
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    Legal Business Name  |    CK PARSON ENTERPRISES 
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Dates
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    Enumeration Date     |    11/04/2010
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    Last Update Date     |    11/04/2010
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Provider Practice Location Address
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    Address Line         |    4201 MACKENZIE DR 
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    City                 |    MOORE
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    State                |    OK
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    Zip                  |    73160-1267
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    Country              |    US
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    Telephone            |    405-570-9564
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    Fax                  |    405-759-3321
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Provider Business Mailing Address
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    Address Line         |    4201 MACKENZIE DR 
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    City                 |    MOORE
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    State                |    OK
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    Zip                  |    73160-1267
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    Country              |    US
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    Telephone            |    405-570-9564
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    Fax                  |    405-759-3321
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Authorized Official
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    Title or Position    |    LICENSE PROFESSIONAL COUNSELOR
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    Name                 |    MS. CINDY L DRISKELL-PARSON 
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    Credential           |    MHR LPC
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    Telephone            |    405-570-9564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    
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    License Number State |    
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