Provider Demographics
NPI:1558782003
Name:PARKER, JILLIAN MARIE (MED)
Entity type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:MARIE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 VALLEYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-3157
Mailing Address - Country:US
Mailing Address - Phone:603-943-1011
Mailing Address - Fax:
Practice Address - Street 1:145 FAUNCE CORNER RD STE K
Practice Address - Street 2:
Practice Address - City:N DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1263
Practice Address - Country:US
Practice Address - Phone:603-943-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-31
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst