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Individual

KATHLEEN PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3070 RASMUSSEN RD STE 280, PARK CITY, UT 84098-5516
(801) 671-1315
Mailing address
PO BOX 982693, PARK CITY, UT 84098-2693
(801) 671-1315

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
37097
ID
1041C0700X
Clinical Social Worker
Primary
68850903501
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
123456789
BLUE CROSS
UT
Enumeration date
03/30/2008
Last updated
10/12/2021
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