Provider Demographics
NPI:1346947314
Name:BRYAN- PARKER, AMBER MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:BRYAN- PARKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10113 UP RIVER RD APT 5103
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78410-1518
Mailing Address - Country:US
Mailing Address - Phone:956-458-9720
Mailing Address - Fax:
Practice Address - Street 1:1700 COVEMEADOW DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-5407
Practice Address - Country:US
Practice Address - Phone:281-836-3704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84035101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional