Individual
MRS. TACHELLE M PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADC
Contact information
Practice address
1245 GARDENIA DR, WINDSOR, PA 17366-8527
(717) 578-7305
Mailing address
3639 REISTERSTOWN RD, BALTIMORE, MD 21215-7701
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3441
MD
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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