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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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