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General NPI Number Information
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NPI Number | 1295456267
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Entity Type | Individual
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Provider Name | JULIA MARY PARKER
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Gender | Female
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Dates
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Enumeration Date | 09/08/2022
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 130 SHADY LANE DR STE D
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City | NORWALK
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State | OH
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Zip | 44857-2710
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Country | US
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Telephone | 567-743-7199
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Fax |
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Provider Business Mailing Address
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Address Line | 3783 BRIDGEVIEW DR
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City | SOUTH EUCLID
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State | OH
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Zip | 44121-1930
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Country | US
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Telephone | 419-366-7023
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.2305514
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License Number State | OH
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