Provider Demographics
NPI:1407988595
Name:PARSELLS, ANN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:PARSELLS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25354 BLUE SKIES RD
Mailing Address - Street 2:
Mailing Address - City:CUSTER
Mailing Address - State:SD
Mailing Address - Zip Code:57730-7113
Mailing Address - Country:US
Mailing Address - Phone:605-673-3488
Mailing Address - Fax:605-673-3496
Practice Address - Street 1:25354 BLUE SKIES RD
Practice Address - Street 2:
Practice Address - City:CUSTER
Practice Address - State:SD
Practice Address - Zip Code:57730-7113
Practice Address - Country:US
Practice Address - Phone:605-673-3488
Practice Address - Fax:605-673-3496
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5835290Medicaid