Provider Demographics
NPI:1073840146
Name:PARISH, SUSAN
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:PARISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 WASHINGTON
Mailing Address - Street 2:#2014
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-4048
Mailing Address - Country:US
Mailing Address - Phone:925-672-9440
Mailing Address - Fax:925-672-9440
Practice Address - Street 1:1460 WASHINGTON BLVD
Practice Address - Street 2:#2014
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-4048
Practice Address - Country:US
Practice Address - Phone:925-672-9440
Practice Address - Fax:925-672-9440
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAN7917647235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist