Provider Demographics
NPI:1861696528
Name:PARKER, SANDY M (BA)
Entity type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:M
Last Name:PARKER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MISS
Other - First Name:SANDY
Other - Middle Name:M
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 FARRAGUT AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5626
Mailing Address - Country:US
Mailing Address - Phone:719-227-7571
Mailing Address - Fax:
Practice Address - Street 1:10 FARRAGUT AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5626
Practice Address - Country:US
Practice Address - Phone:719-227-7571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2016-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor