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General NPI Number Information
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NPI Number | 1285024190
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Entity Type | Organization
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Legal Business Name | JANICE M. PARKS, LMSW
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Dates
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Enumeration Date | 01/30/2015
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 5321 SHADOWRIDGE CT
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City | WICHITA
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State | KS
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Zip | 67220-4260
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Country | US
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Telephone | 316-204-9571
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Fax | 316-765-0105
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Provider Business Mailing Address
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Address Line | 5321 SHADOWRIDGE CT
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City | WICHITA
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State | KS
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Zip | 67220-4260
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Country | US
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Telephone | 316-204-9571
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Fax | 316-765-0105
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Authorized Official
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Title or Position | PROVIDER/ ONWER
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Name | JANICE M PARKS
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Credential | LMSW
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Telephone | 316-204-9571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 8614
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License Number State | KS
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