Provider Demographics
NPI:1669633939
Name:PARKER, PATRICIA JEANNE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JEANNE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 UPPER DRENNEN RD
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-1638
Mailing Address - Country:US
Mailing Address - Phone:412-977-5026
Mailing Address - Fax:
Practice Address - Street 1:1215 HULTON RD
Practice Address - Street 2:
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-1135
Practice Address - Country:US
Practice Address - Phone:412-826-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007958235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist