Provider Demographics
NPI:1356443899
Name:PARKER, JOLIE ANNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOLIE
Middle Name:ANNE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2902 PORTSMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-3127
Mailing Address - Country:US
Mailing Address - Phone:863-258-3446
Mailing Address - Fax:
Practice Address - Street 1:2902 PORTSMOUTH ST
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32738-3127
Practice Address - Country:US
Practice Address - Phone:407-766-8625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7772235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist