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General NPI Number Information
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NPI Number | 1366381162
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Entity Type | Individual
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Provider Name | MARTINA BEATRICE PARKS
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Gender | Female
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 2041 MARTIN LUTHER KING JR AVE SE STE 402
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City | WASHINGTON
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State | DC
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Zip | 20020-7024
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Country | US
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Telephone | 187-765-9450
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Fax | 188-897-2389
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Provider Business Mailing Address
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Address Line | 2442 MARTIN LUTHER KING JR AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20020-5800
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Country | US
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Telephone | 180-046-5320
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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 | 103TE1100X
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Taxonomy Name | Exercise & Sports Psychologist
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License Number |
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License Number State |
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