Provider Demographics
NPI:1609064849
Name:PARSONS, TARA SUE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:SUE
Last Name:PARSONS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 BLACK GOLD BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-2620
Mailing Address - Country:US
Mailing Address - Phone:606-439-1331
Mailing Address - Fax:606-439-6629
Practice Address - Street 1:210 BLACK GOLD BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-2620
Practice Address - Country:US
Practice Address - Phone:606-439-1331
Practice Address - Fax:606-439-6629
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2008-100103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist