Provider Demographics
NPI:1346551264
Name:PARKER, MARILYN F (MS, CCC)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:F
Last Name:PARKER
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 E 31ST ST
Mailing Address - Street 2:P.H.
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4210
Mailing Address - Country:US
Mailing Address - Phone:718-627-4584
Mailing Address - Fax:
Practice Address - Street 1:1609 E 31ST ST
Practice Address - Street 2:P.H.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4210
Practice Address - Country:US
Practice Address - Phone:718-627-4584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002387235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist