Individual
CAROL A. PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, RD, LD, CEDRED
Contact information
Practice address
1702 N. COLLINS BLVD. STE 207, RICHARDSON, TX 75080-3550
(469) 324-9744
(972) 591-2943
Mailing address
1702 N COLLINS BLVD STE 207, RICHARDSON, TX 75080-3550
(469) 324-9744
(972) 671-2087
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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