Individual
TINA MARIE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
12948 COLDWATER RD STE 101, FORT WAYNE, IN 46845-8016
(260) 373-0880
(260) 373-0881
Mailing address
3894 NEW VISION DR, FORT WAYNE, IN 46845-1708
(260) 373-0880
(260) 373-0881
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
35002150A
IN
Other
Enumeration date
05/10/2019
Last updated
01/24/2023
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