Provider Information for 1558781815
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Mrs. BRENDA LUCILLE PARKER N.C.C., L.P.C.-S
Sex: Female
NPI: 1558781815
Last Updated: 2014-04-24
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1558781815 | ||||||||||||
| Enumeration Date | 2014-04-24 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 10004 SUNNY SIDE LN TEMPLE, TX 76502-5370 United States Phone: 254-493-3152 | Fax: | ||||||||||||
| Primary Practice Address | 10004 SUNNY SIDE LN TEMPLE, TX 76502-5370 United States Phone: 254-493-3152 | Fax: | ||||||||||||
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