MEDICARE: MRS. DESIRE PARKS CD

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	374J00000X	Doula	DOU000228	OH

General Provider Information

NPI Number	:	1407714330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DESIRE PARKS CD

Provider Business Mailing Address
First Line	:	PO BOX 1036
Second Line	:
City	:	NEW ALBANY
State	:	OH
Zip	:	43054-1036
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7284 COLONIAL AFFAIR DR
Second Line	:
City	:	NEW ALBANY
State	:	OH
Zip	:	43054-8104
Country	:	US
Telephone Number	:	330-622-2983
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ MRS. DESIRE PARKS CD” Practice Location

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