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General NPI Number Information
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NPI Number | 1952779522
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Entity Type | Organization
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Legal Business Name | JOHN C PARKER LLC
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Dates
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Enumeration Date | 09/12/2015
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Last Update Date | 09/12/2015
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Provider Practice Location Address
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Address Line | 10 WESTOWNE ST
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City | LIBERTY
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State | MO
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Zip | 64068-1166
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Country | US
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Telephone | 816-343-8041
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Fax | 816-407-7706
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Provider Business Mailing Address
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Address Line | 10 WESTOWNE ST
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City | LIBERTY
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State | MO
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Zip | 64068-1166
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Country | US
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Telephone | 816-343-8041
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Fax | 816-407-7706
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Authorized Official
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Title or Position | MEMBER
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Name | JOHN CHARLES PARKER
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Credential | JOHN PARKER LMFT
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Telephone | 816-343-8041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2012041377
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License Number State | MO
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