Provider Demographics
NPI:1013451814
Name:PARRISH, JESSICA MARIE
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:MARIE
Last Name:PARRISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9065 SHORT CUT RD
Mailing Address - Street 2:
Mailing Address - City:IRA
Mailing Address - State:MI
Mailing Address - Zip Code:48023-1910
Mailing Address - Country:US
Mailing Address - Phone:586-738-4885
Mailing Address - Fax:
Practice Address - Street 1:44738 MORLEY DR
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-1357
Practice Address - Country:US
Practice Address - Phone:586-421-4062
Practice Address - Fax:586-421-4072
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101005377235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist