Individual
DR. ELOISE PORTE PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
92 LAKESHORE DR, MALTA, NY 12020-6240
(518) 429-8792
Mailing address
92 LAKESHORE DR, BALLSTON SPA, NY 12020-6240
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
011123
NY
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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