| George S. Park, Phd., Mp., A Psychology Corporation | |
|
2285 Benton Rd Ste 401 Bossier City LA 71111-7933 | |
| (318) 415-8755 | |
| (318) 746-8565 |
| Full Name | George S. Park, Phd., Mp., A Psychology Corporation |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 2285 Benton Rd Ste 401, Bossier City, Louisiana |
| Authorized Official Name and Position | Mary S Park (OFFICE MANAGER) |
| Authorized Official Contact | 3184158755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| George S. Park, Phd., Mp., A Psychology Corporation Po Box 5478 Bossier City LA 71171-5478 Ph: (318) 415-8755 | George S. Park, Phd., Mp., A Psychology Corporation 2285 Benton Rd Ste 401 Bossier City LA 71111-7933 Ph: (318) 415-8755 |
| NPI Number | 1790297182 |
|---|---|
| Provider Enumeration Date | 10/25/2017 |
| Last Update Date | 10/25/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790297182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | (* (Not Available)) | Primary |
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