Individual
RYAN PARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASUDC
Contact information
Practice address
474 W 200 N STE 200, ST GEORGE, UT 84770-4505
(435) 634-5600
Mailing address
474 W 200 N STE 200, ST GEORGE, UT 84770-4505
(435) 634-5600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
10564656-6018
UT
104100000X
Social Worker
Primary
10564656-3502
UT
Other
Enumeration date
11/15/2018
Last updated
07/21/2020
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