Provider Demographics
NPI:1255443172
Name:PARKER, VICKI S (PHD)
Entity type:Individual
Prefix:DR
First Name:VICKI
Middle Name:S
Last Name:PARKER
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:11030 GOLF LINKS DR N
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8200
Mailing Address - Country:US
Mailing Address - Phone:704-541-1373
Mailing Address - Fax:704-541-7559
Practice Address - Street 1:1100 S CLINTON AVENUE
Practice Address - Street 2:SUITE C
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334
Practice Address - Country:US
Practice Address - Phone:910-892-0027
Practice Address - Fax:910-892-0029
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-05-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC6615235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211634Medicaid
NC7211634Medicaid