Individual provider · Type 1 NPI
George S. Park, PhD, M.P.
Prescribing (Medical) Psychologist · Bossier City, LA
Practice location
2285 Benton Rd Bldg 3, Suite 401
Bossier City, LA 71111-7933
Fax (318) 746-8565
Mailing address
PO Box 5478
Bossier City, LA 71171-5478
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Prescribing (Medical) Psychologist Primary | 103TP0016X | MP0983 (LA) |
Prescribing (Medical) Psychologist: A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or…
About NPI 1437199031
George S. Park, PhD, M.P.'s National Provider Identifier is 1437199031, issued on Jun 8, 2006. The primary taxonomy on file is Prescribing (Medical) Psychologist (103TP0016X), and the practice location is in Bossier City, LA. The record was last updated on Jan 11, 2016.