Provider Demographics
NPI:1740569094
Name:PARRISH, MARY MOLLEUR (AUD CCC-A)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MOLLEUR
Last Name:PARRISH
Suffix:
Gender:F
Credentials:AUD CCC-A
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ALICIA
Other - Last Name:MOLLEUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD CCC-A
Mailing Address - Street 1:30 CANTON ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3524
Mailing Address - Country:US
Mailing Address - Phone:603-622-3623
Mailing Address - Fax:
Practice Address - Street 1:30 CANTON ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3524
Practice Address - Country:US
Practice Address - Phone:603-622-3623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA955231H00000X
NHA633231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist