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Individual

JOHN PARKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1228 NE 18TH ST, OKLAHOMA CITY, OK 73111-1012
(405) 798-4577
Mailing address
1228 NE 18TH ST, OKLAHOMA CITY, OK 73111-1012

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000
DEPARTMENT OF MENTAL HEALTH
Enumeration date
08/31/2011
Last updated
08/31/2011
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