Provider Demographics
NPI:1164608469
Name:PARKER, AMY (SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CROCKETT CIR
Mailing Address - Street 2:
Mailing Address - City:HOPEDALE
Mailing Address - State:MA
Mailing Address - Zip Code:01747-1840
Mailing Address - Country:US
Mailing Address - Phone:508-634-0545
Mailing Address - Fax:
Practice Address - Street 1:3 ELECTRONICS AVE
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1099
Practice Address - Country:US
Practice Address - Phone:978-750-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4246235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist