Individual
SHANA PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SC.D.
Contact information
Practice address
936 RAIN LILLY LN, BOULDER, CO 80304-0791
(303) 447-2747
Mailing address
936 RAIN LILLY LN, BOULDER, CO 80304-0791
(303) 447-2747
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1441
CO
Other
Enumeration date
02/15/2017
Last updated
02/15/2017
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