Provider Demographics
NPI:1871815860
Name:PARKER, MONICA CANTRELL (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:CANTRELL
Last Name:PARKER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 THORNBRIAR WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:GA
Mailing Address - Zip Code:30563-3546
Mailing Address - Country:US
Mailing Address - Phone:706-776-6850
Mailing Address - Fax:
Practice Address - Street 1:229 THORNBRIAR WAY
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:GA
Practice Address - Zip Code:30563-3546
Practice Address - Country:US
Practice Address - Phone:706-776-6850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004902235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist