Individual
MACKENZIE B PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMSW, PLMHP
Contact information
Practice address
3549 FONTENELLE BLVD, OMAHA, NE 68104-3601
(402) 451-0787
Mailing address
4939 S 118TH ST, OMAHA, NE 68137-2213
(402) 451-0787
(402) 898-7750
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11637
NE
Other
Enumeration date
09/29/2018
Last updated
09/29/2018
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