Individual
MS. CAMILLE IRENE PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LIC.PSYCH.-MASTER
Contact information
Practice address
1462 GREEN MOUNTAIN TPKE, CHESTER, VT 05143-8874
(802) 875-2672
Mailing address
1 ROCK DR, LUDLOW, VT 05149-1322
(802) 228-7967
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
047-0000601
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004750
—
VT
Enumeration date
10/01/2006
Last updated
07/09/2007
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