Individual
LATIA R PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC, LPC
Contact information
Practice address
2508 E 71ST ST, SUITE C, TULSA, OK 74136-5572
(918) 794-6570
(918) 340-5189
Mailing address
200 W HOBSON AVE, SAPULPA, OK 74066-3926
(918) 902-5348
(918) 224-6837
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
659
OK
101YP2500X
Professional Counselor
Primary
3343
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200232480A
—
OK
Enumeration date
01/14/2009
Last updated
09/30/2015
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