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NPI Code Detail

MEDICARE: MS. AMY AVANELLE PARKER MS., LPC

MEDICARE: MS. AMY AVANELLE PARKER MS., LPC
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

General Provider Information

NPI Number : 1639366552
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMY AVANELLE PARKER MS., LPC
Provider Business Mailing Address
First Line : 7777 E US HIGHWAY 66
Second Line :
City : EL RENO
State : OK
Zip : 73036-9125
Country : US
Telephone Number : 405-422-8814
Fax Number :
Provider Business Practice Location Address
First Line : 7777 E US HIGHWAY 66
Second Line :
City : EL RENO
State : OK
Zip : 73036-9125
Country : US
Telephone Number : 405-422-8814
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2007
Last Update Date : 04/18/2018

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