Provider Demographics
NPI:1639612385
Name:PARKER, CHRISTINE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11450 OLD 2243 W
Mailing Address - Street 2:APT. 1329
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-1982
Mailing Address - Country:US
Mailing Address - Phone:512-644-1857
Mailing Address - Fax:
Practice Address - Street 1:11450 OLD 2243 W
Practice Address - Street 2:APT. 1329
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-1982
Practice Address - Country:US
Practice Address - Phone:512-644-1857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108619235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist