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NPI Code Detail

MEDICARE: JACQUELYN PARKE

MEDICARE: JACQUELYN PARKE
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
1103K00000XBehavior Analyst1-24-76080

General Provider Information

NPI Number : 1194546085
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELYN PARKE
Provider Business Mailing Address
First Line : 2105 LAWRENCE AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43606-4822
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2105 LAWRENCE AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43606-4822
Country : US
Telephone Number : 419-291-7080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2024
Last Update Date : 01/14/2026

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Directions to “ JACQUELYN PARKE ” Practice Location

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