Provider Demographics
NPI:1013150903
Name:PARKER, MARY FRANCES (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:FRANCES
Last Name:PARKER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:FRANCES
Other - Last Name:O'LEARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5372 TIMBERLINE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-1020
Mailing Address - Country:US
Mailing Address - Phone:904-762-7723
Mailing Address - Fax:
Practice Address - Street 1:5372 TIMBERLINE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-1020
Practice Address - Country:US
Practice Address - Phone:904-762-7723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA611235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist