MEDICARE: DR. RICHARD DEAN PARSONS PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	002608-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000136510	OTHER	PA	INDEPEND BLUE CROSS

General Provider Information

NPI Number	:	1073686473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD DEAN PARSONS PH.D.

Provider Business Mailing Address
First Line	:	1501 MCDANIEL DR
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-6671
Country	:	US
Telephone Number	:	610-430-8121
Fax Number	:	610-430-8765

Provider Business Practice Location Address
First Line	:	1501 MCDANIEL DR
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-6671
Country	:	US
Telephone Number	:	610-430-8121
Fax Number	:	610-430-8765

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/08/2007

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