Individual
NICHOLAS PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
2200 VALLEYDALE RD STE 107, HOOVER, AL 35244-2719
(205) 600-0134
Mailing address
1097 HIGHLAND VILLAGE TRL, BIRMINGHAM, AL 35242-6651
(205) 914-2556
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083133003
—
AL
Enumeration date
04/23/2019
Last updated
04/23/2019
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