Individual
CAROL A. PARK
Active
Individual
CAROL A. PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, RD, LD, CEDRED
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
66588
TX
101YP2500X
Professional Counselor
66588
TX
133V00000X
Registered Dietitian
Primary
DT02795
TX
Other
Enumeration date
11/01/2006
Last updated
08/24/2020
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