Provider Demographics
NPI:1699007757
Name:PARISH, MICHELLE RENEE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENEE
Last Name:PARISH
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27880 RIATA RANCH DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2517
Mailing Address - Country:US
Mailing Address - Phone:210-870-9430
Mailing Address - Fax:210-568-4995
Practice Address - Street 1:27880 RIATA RANCH DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78261-2517
Practice Address - Country:US
Practice Address - Phone:210-870-9430
Practice Address - Fax:210-568-4995
Is Sole Proprietor?:No
Enumeration Date:2010-01-31
Last Update Date:2010-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18579235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist