Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | C7868 | MS |
NPI | 1003202391 |
---|---|
Provider Name | Meagan Parker |
First Address | Biloxi, MS 39530-2935 |
Second Address | Biloxi, MS 39530-2935 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2015 |
Last Update Date | 13/04/2015 |