Individual
MR. BRUCE SHEA PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LCSW
Contact information
Practice address
48 COUNTRY CLUB LN, WOODSTOCK, NY 12498-1839
(845) 679-5464
Mailing address
48 COUNTRY CLUB LN, WOODSTOCK, NY 12498-1839
(845) 679-5464
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
070208
NY
Other
Enumeration date
06/26/2008
Last updated
06/26/2008
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