Organization
LAKE BEHAVIORAL HEALTH ASSOCIATES, LLC
Active
Organization
LAKE BEHAVIORAL HEALTH ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE E. PARKER PSYD (PRESIDENT)
(573) 693-9090
Entity
Organization
Contact information
Practice address
5529B OSAGE BEACH PKWY, OSAGE BEACH, MO 65065-3023
(573) 693-9090
Mailing address
PO BOX 449, OSAGE BEACH, MO 65065-0449
(573) 693-9090
(573) 348-1858
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
06/09/2006
Last updated
10/03/2022
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