Provider Demographics
NPI:1487700720
Name:PARKER, BECKY D (PHD)
Entity type:Individual
Prefix:DR
First Name:BECKY
Middle Name:D
Last Name:PARKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 N WHEELER AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2633
Mailing Address - Country:US
Mailing Address - Phone:479-444-8989
Mailing Address - Fax:479-444-7545
Practice Address - Street 1:2755 E KANTZ DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-3212
Practice Address - Country:US
Practice Address - Phone:479-444-8989
Practice Address - Fax:479-444-7545
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR05-19P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical