Individual
KAREN MICHELLE PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4212 CORAL PARK DR STE E, BRUNSWICK, GA 31520-3016
(912) 996-2069
(912) 265-0041
Mailing address
4212 CORAL PARK DR, BRUNSWICK, GA 31520-3016
(912) 996-2069
(912) 265-0041
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT001375
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
760528954A
—
GA
Enumeration date
10/25/2006
Last updated
06/19/2019
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