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NPI Code Detail

MEDICARE: VICKIE PARKER

MEDICARE: VICKIE PARKER
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
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1184985822
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKIE PARKER
Provider Business Mailing Address
First Line : 9540 JOURNEY DR
Second Line :
City : SHERWOOD
State : AR
Zip : 72120-4345
Country : US
Telephone Number : 501-541-1862
Fax Number :
Provider Business Practice Location Address
First Line : 7107 W 12TH ST STE 201
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72204-2451
Country : US
Telephone Number : 501-541-1862
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2012
Last Update Date : 01/24/2016

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Directions to “ VICKIE PARKER ” Practice Location

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