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General NPI Number Information
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NPI Number | 1821339250
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Entity Type | Organization
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Legal Business Name | WILLIAM PARKER PHD PC
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Dates
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Enumeration Date | 03/11/2013
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Last Update Date | 03/11/2013
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Provider Practice Location Address
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Address Line | 2894 THORNAPPLE RIVER DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-6857
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Country | US
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Telephone | 616-285-6080
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Fax | 616-285-5466
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Provider Business Mailing Address
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Address Line | 2894 THORNAPPLE RIVER DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-6857
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Country | US
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Telephone | 616-285-6080
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Fax | 616-285-5466
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM L PARKER III
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Credential | PHD
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Telephone | 616-285-6080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301007243
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License Number State | MI
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