Provider Demographics
NPI:1659855492
Name:PARKER, ASHIA
Entity Type:Individual
Prefix:
First Name:ASHIA
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 1:1921 SE HILLMOOR DR APT 100
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7756
Mailing Address - Country:US
Mailing Address - Phone:863-873-3996
Mailing Address - Fax:
Practice Address - Street 1:1921 SE HILLMOOR DR APT 100
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7756
Practice Address - Country:US
Practice Address - Phone:863-873-3996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services