Parks, Jacqueline Diane
Parks, Jacqueline Diane is an sole proprietor health care provider with primary practice located at 19291 Northline Rd , Southgate MI 48195-2220. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Parks, Jacqueline Diane can be contacted via phone (734) 785-7700.Contact Information
Primary practice address
19291 Northline Rd
Southgate MI 48195-2220
Phone: (734) 785-7700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 6301015305 | Michigan |
Profile Details
| NPI number | 1194069500 |
|---|---|
| LBN Legal business name | Parks, Jacqueline Diane |
| Credentials | MA, TLLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 26th, 2012 |
| Last updated | Nov 26th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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