Provider Demographics
NPI:1356681126
Name:PARKER, KRISTAN M
Entity Type:Individual
Prefix:MS
First Name:KRISTAN
Middle Name:M
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 1:4121 CHATEAU BLVD
Mailing Address - Street 2:APT C
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-5709
Mailing Address - Country:US
Mailing Address - Phone:985-852-0059
Mailing Address - Fax:
Practice Address - Street 1:2626 CHARLES DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-3779
Practice Address - Country:US
Practice Address - Phone:504-278-4006
Practice Address - Fax:504-278-4007
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor