Provider Demographics
NPI:1285404889
Name:PARKER, KAREN PATRICE (MS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:PATRICE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:PATRICE
Other - Last Name:PARKER SWANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12263 W HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-1433
Mailing Address - Country:US
Mailing Address - Phone:208-450-9167
Mailing Address - Fax:
Practice Address - Street 1:12263 W HICKORY DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-1433
Practice Address - Country:US
Practice Address - Phone:208-450-9167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst