Provider Demographics
NPI:1790861235
Name:PARKER, MOLLY (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:
Other - Last Name:MCWHINNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806-5450
Mailing Address - Country:US
Mailing Address - Phone:563-326-5441
Mailing Address - Fax:888-336-4118
Practice Address - Street 1:3601 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-5450
Practice Address - Country:US
Practice Address - Phone:563-326-5441
Practice Address - Fax:888-336-4118
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00462231H00000X
IA462,737237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0215384Medicaid
IA0215384Medicaid