Provider Demographics
NPI:1407292675
Name:PARKS, TAMURA (BS, MSW)
Entity Type:Individual
Prefix:
First Name:TAMURA
Middle Name:
Last Name:PARKS
Suffix:
Gender:F
Credentials:BS, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3823 PIERSON DR W
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36619-1275
Mailing Address - Country:US
Mailing Address - Phone:251-802-7600
Mailing Address - Fax:
Practice Address - Street 1:2411 S US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-8258
Practice Address - Country:US
Practice Address - Phone:251-300-6906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health