Provider Demographics
NPI:1760612006
Name:PARKER, ALLISON O'STEEN (MACCCSLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:O'STEEN
Last Name:PARKER
Suffix:
Gender:F
Credentials:MACCCSLP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:KATHRYN
Other - Last Name:O'STEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4012 PARK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2377
Mailing Address - Country:US
Mailing Address - Phone:704-332-4834
Mailing Address - Fax:704-372-9653
Practice Address - Street 1:4012 PARK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-2377
Practice Address - Country:US
Practice Address - Phone:704-332-4834
Practice Address - Fax:704-372-9653
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007120235Z00000X
NC10978235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003108706AMedicaid