Provider Demographics
NPI:1619221728
Name:PARKER, ABIGAIL MARIE (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:MARIE
Last Name:PARKER
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W ONEIL DR
Mailing Address - Street 2:APT. 1111
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-1166
Mailing Address - Country:US
Mailing Address - Phone:937-654-5768
Mailing Address - Fax:
Practice Address - Street 1:220 W KORTSEN RD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5910
Practice Address - Country:US
Practice Address - Phone:520-876-3242
Practice Address - Fax:520-876-3646
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA80742355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant