Provider Demographics
NPI:1093975286
Name:PARKER, REBECCA L (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:L
Last Name:PARKER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 MAJOR AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-2342
Mailing Address - Country:US
Mailing Address - Phone:307-856-6587
Mailing Address - Fax:307-856-2668
Practice Address - Street 1:1110 MAJOR AVE
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-2342
Practice Address - Country:US
Practice Address - Phone:307-856-6587
Practice Address - Fax:307-856-2668
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC 769101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional