Basic Information
| Provider Information | |||||||||
| NPI: | 1285925594 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARKER | ||||||||
| FirstName: | MARCIE | ||||||||
| MiddleName: | ALLYN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS LCGC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4701 OGLETOWN-STANTON ROAD | ||||||||
| Address2: | SUITE 2236 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026234543 | ||||||||
| FaxNumber: | 3026234845 | ||||||||
| Practice Location | |||||||||
| Address1: | 4701 OGLETOWN-STANTON ROAD | ||||||||
| Address2: | SUITE 2236 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197132236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026234543 | ||||||||
| FaxNumber: | 3026234845 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2011 | ||||||||
| LastUpdateDate: | 04/21/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 170300000X | 0000006 | DE | Y | Other Service Providers | Genetic Counselor, MS |
No ID Information.