MEDICARE: LAUREN R PARKER PSY.S

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	103TS0200X	School Psychologist		FL

General Provider Information

NPI Number	:	1922724152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN R PARKER PSY.S

Provider Business Mailing Address
First Line	:	1128 TROTWOOD BLVD
Second Line	:
City	:	WINTER SPGS
State	:	FL
Zip	:	32708-6211
Country	:	US
Telephone Number	:	772-486-2184
Fax Number	:

Provider Business Practice Location Address
First Line	:	1128 TROTWOOD BLVD
Second Line	:
City	:	WINTER SPGS
State	:	FL
Zip	:	32708-6211
Country	:	US
Telephone Number	:	772-486-2184
Fax Number	:

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

Provider Enumeration Date	:	10/19/2022
Last Update Date	:	10/19/2022

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