Provider Demographics
NPI:1952646937
Name:PARKER, TYLER (MCD, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TYLER
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12784 JASMINE ST
Mailing Address - Street 2:UNIT C
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-4652
Mailing Address - Country:US
Mailing Address - Phone:334-414-8193
Mailing Address - Fax:
Practice Address - Street 1:12784 JASMINE ST
Practice Address - Street 2:UNIT C
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80602-4652
Practice Address - Country:US
Practice Address - Phone:334-414-8193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12121431235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist