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Individual

RANDY L PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH D

Contact information

Practice address
240 N ROCK RD, SUITE 303, WICHITA, KS 67206
(316) 684-3010
(316) 686-7366
Mailing address
240 N ROCK RD, SUITE 303, WICHITA, KS 67206
(316) 684-3010
(316) 686-7366

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1045
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100370650A
KS
Enumeration date
07/21/2006
Last updated
07/08/2007
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