Individual
MARIE BERNADINE PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
351 REGENCY RIDGE DR, CENTERVILLE, OH 45459-4252
(937) 260-0730
Mailing address
314 PHILLIPS ST, YELLOW SPRINGS, OH 45387-1769
(937) 260-0730
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E0001872
OH
Other
Enumeration date
02/10/2014
Last updated
02/10/2014
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