Provider Demographics
NPI:1477513109
Name:PARKER, MARGARET ANN (SLP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:PARKER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 E SHOTWELL ST
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-4063
Mailing Address - Country:US
Mailing Address - Phone:229-246-4088
Mailing Address - Fax:229-243-0200
Practice Address - Street 1:713 E SHOTWELL ST
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-4063
Practice Address - Country:US
Practice Address - Phone:229-246-4088
Practice Address - Fax:229-243-0200
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP000738235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00626392BMedicaid