Individual
TIMOTHY PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
109 BOTANY BAY BLVD, NORTH CHARLESTON, SC 29418-3003
(716) 946-3138
Mailing address
109 BOTANY BAY BLVD, NORTH CHARLESTON, SC 29418-3003
(716) 946-3138
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1890
SC
103TH0100X
Health Service Psychologist
025551-01
NY
Other
Enumeration date
07/10/2024
Last updated
09/05/2024
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