Provider Demographics
NPI:1073031027
Name:PARKER, DINA MICHELLE
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:MICHELLE
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5640 READ BLVD STE 740
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70127-3131
Mailing Address - Country:US
Mailing Address - Phone:504-245-2440
Mailing Address - Fax:504-245-4284
Practice Address - Street 1:5640 READ BLVD
Practice Address - Street 2:SUITE 740
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127
Practice Address - Country:US
Practice Address - Phone:504-245-2440
Practice Address - Fax:504-245-4284
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1063728491Medicaid