Provider Demographics
NPI:1073032751
Name:PARKER, KYRZIA ANN
Entity type:Individual
Prefix:
First Name:KYRZIA
Middle Name:ANN
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4833 FRONT ST STE B
Mailing Address - Street 2:#600
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-7901
Mailing Address - Country:US
Mailing Address - Phone:720-507-7017
Mailing Address - Fax:
Practice Address - Street 1:4833 FRONT ST STE B
Practice Address - Street 2:#600
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-7901
Practice Address - Country:US
Practice Address - Phone:720-507-7017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099249411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical