Provider Demographics
NPI:1407492697
Name:PARRISH, THERESA (CPHT)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:PARRISH
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 EARL L CORE RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-5889
Mailing Address - Country:US
Mailing Address - Phone:042-696-7721
Mailing Address - Fax:
Practice Address - Street 1:1601 EARL L CORE RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-5889
Practice Address - Country:US
Practice Address - Phone:304-296-7721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other