Organization
GEORGE S. PARK, PHD., MP., A PSYCHOLOGY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY S PARK (OFFICE MANAGER)
(318) 415-8755
Entity
Organization
Contact information
Practice address
2285 BENTON RD STE 401, BOSSIER CITY, LA 71111-7933
(318) 415-8755
(318) 746-8565
Mailing address
PO BOX 5478, BOSSIER CITY, LA 71171-5478
(318) 415-8755
(318) 746-8565
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
—
—
Other
Enumeration date
10/25/2017
Last updated
10/25/2017
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