Provider Demographics
NPI:1881939742
Name:PARKS, ALYSON MARIE
Entity type:Individual
Prefix:MS
First Name:ALYSON
Middle Name:MARIE
Last Name:PARKS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ALYSON
Other - Middle Name:MARIE
Other - Last Name:SYLVESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4520 SUNNYVIEW DR
Mailing Address - Street 2:APT243
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-3114
Mailing Address - Country:US
Mailing Address - Phone:405-201-2123
Mailing Address - Fax:
Practice Address - Street 1:301 W I 240 SERVICE RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-7701
Practice Address - Country:US
Practice Address - Phone:405-635-3800
Practice Address - Fax:405-604-9689
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)