Provider Demographics
NPI:1790811495
Name:PARKER, JESSICA G (SLP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:G
Last Name:PARKER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:G
Other - Last Name:NEMSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:17830 NEW HAMPSHIRE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ASHTON
Mailing Address - State:MD
Mailing Address - Zip Code:20861-3644
Mailing Address - Country:US
Mailing Address - Phone:301-323-8486
Mailing Address - Fax:240-422-8283
Practice Address - Street 1:17830 NEW HAMPSHIRE AVE STE 300
Practice Address - Street 2:
Practice Address - City:ASHTON
Practice Address - State:MD
Practice Address - Zip Code:20861-3644
Practice Address - Country:US
Practice Address - Phone:301-323-8486
Practice Address - Fax:240-422-8283
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06588235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD212044501Medicaid