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NPI Code Detail

MEDICARE: CLAIRE MARY PARKER LADC

MEDICARE: CLAIRE MARY PARKER LADC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor300829MN

General Provider Information

NPI Number : 1235329285
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAIRE MARY PARKER LADC
Provider Business Mailing Address
First Line : 2616 NICOLLET AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-1628
Country : US
Telephone Number : 612-871-7878
Fax Number :
Provider Business Practice Location Address
First Line : 2616 NICOLLET AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-1628
Country : US
Telephone Number : 612-871-7878
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2007
Last Update Date : 07/26/2007

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Directions to “ CLAIRE MARY PARKER LADC” Practice Location

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