| Doctor Name: | DR. BONNIE JO PARKER |
| NPI Number: | 1073698072 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 6301013183 |
| Business Practice Address: | 8062 Ortonville Rd Clarkston, MI - 483484456 |
| Business Phone Number: | 2486252970 |
| Business Fax Number: | |
| Mailing Address: | 8864 Big Lake Rd, CLARKSTON |
| State: | MI |
| Postal Code: | 483461010 |
| Phone Number: | 2489229222 |
| Fax Number: | |
| NPI Enumeration Date: | 10/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301013183 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |