Provider Demographics
NPI:1578680328
Name:PARKER, MOLLY ETHEL (BA)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:ETHEL
Last Name:PARKER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:ETHEL
Other - Last Name:SMALLWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1327 E PRICE ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19138-1914
Mailing Address - Country:US
Mailing Address - Phone:215-848-9324
Mailing Address - Fax:
Practice Address - Street 1:112 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19102-1510
Practice Address - Country:US
Practice Address - Phone:215-568-0860
Practice Address - Fax:215-568-0769
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor