Provider Demographics
NPI:1992483770
Name:PARKER, ANNA JANE (PLMFT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:JANE
Last Name:PARKER
Suffix:
Gender:F
Credentials:PLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15455 CONWAY RD STE 117
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2022
Mailing Address - Country:US
Mailing Address - Phone:636-675-7566
Mailing Address - Fax:
Practice Address - Street 1:15455 CONWAY RD STE 117
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2022
Practice Address - Country:US
Practice Address - Phone:636-675-7566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022044899106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist