Provider Demographics
NPI:1003063439
Name:PARKER, NATALIE (MA, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 HERITAGE CENTER DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587
Mailing Address - Country:US
Mailing Address - Phone:919-219-5277
Mailing Address - Fax:919-573-0478
Practice Address - Street 1:1780 HERITAGE CENTER DR
Practice Address - Street 2:SUITE 204
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587
Practice Address - Country:US
Practice Address - Phone:919-219-5277
Practice Address - Fax:919-573-0478
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7887235Z00000X
NC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7200222Medicaid
NC7413032Medicaid