Provider Demographics
NPI:1144729096
Name:PARKER, AMY MARGARET (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:MARGARET
Last Name:PARKER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PARK RD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-2065
Mailing Address - Country:US
Mailing Address - Phone:339-221-0383
Mailing Address - Fax:
Practice Address - Street 1:1121 WASHINGTON ST STE 1
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02465-2150
Practice Address - Country:US
Practice Address - Phone:339-221-0383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA67304103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty