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Individual

KEYLA PARKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
58026 FORT ST, PLAQUEMINE, LA 70764-3222
(225) 685-1163
Mailing address
12224 KINGSTON DR, BATON ROUGE, LA 70807-2072
(225) 978-8601

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
600723334
SEASIDE
LA
Enumeration date
07/15/2015
Last updated
10/02/2015
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