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General NPI Number Information
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NPI Number | 1871899062
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Entity Type | Individual
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Provider Name | BRENDA CAROL PARKER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 815 JOHN HARPER RD UNIT 13
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City | PIONEER VILLAGE
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State | KY
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Zip | 40165-7463
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Country | US
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Telephone | 502-504-5231
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Fax | 502-504-5205
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Provider Business Mailing Address
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Address Line | 815 JOHN HARPER HIGHWAY STE 13
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City | PIONEER VILLAGE
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State | KY
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Zip | 40165-7463
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Country | US
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Telephone | 502-504-5231
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Fax | 502-504-5205
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 129682
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 129682
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License Number State | KY
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