Individual
MS. DIANE LOUISE PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCLS
Contact information
Practice address
2709 COMMONWEALTH AVENUE, APARTMENT 21, CHARLOTTE, NC 28205
(770) 639-1251
Mailing address
2709 COMMONWEALTH AVE, APT 21, CHARLOTTE, NC 28205-5322
(770) 639-1251
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/13/2012
Last updated
01/13/2012
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