Provider Demographics
NPI:1891766374
Name:PARKER, MARY E (MS)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:PARKER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 541044
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32854-1044
Mailing Address - Country:US
Mailing Address - Phone:407-895-0140
Mailing Address - Fax:
Practice Address - Street 1:3222 CORRINE DR
Practice Address - Street 2:SUITE J
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-2217
Practice Address - Country:US
Practice Address - Phone:407-895-0140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4548101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health