Individual
JERRY PARKER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
800 HOSPITAL DR, COLUMBIA, MO 65201-5275
(573) 814-6550
Mailing address
800 HOSPITAL DR, COLUMBIA, MO 65201-5275
(573) 814-6550
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
PYR0055
MO
Other
Enumeration date
04/19/2006
Last updated
07/08/2007
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