Individual
MARY M PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
109 W MALL DR, CORSICANA, TX 75110-3102
(903) 872-6727
Mailing address
109 W MALL DR, CORSICANA, TX 75110-3102
(903) 872-6727
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11538
TX
Other
Enumeration date
02/18/2016
Last updated
02/18/2016
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