Provider Demographics
NPI:1457474777
Name:PARNELL, SHANNON KELLY (MS, CCC-SLP, PC)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:KELLY
Last Name:PARNELL
Suffix:
Gender:F
Credentials:MS, CCC-SLP, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26208 RUDALE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-9658
Mailing Address - Country:US
Mailing Address - Phone:703-869-6085
Mailing Address - Fax:
Practice Address - Street 1:2301 RESEARCH BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3204
Practice Address - Country:US
Practice Address - Phone:301-424-5200
Practice Address - Fax:301-424-8063
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002691235Z00000X
MD06036235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist