Provider Demographics
NPI:1396235776
Name:PARKER, RACHEL (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3081 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:MARATHON
Mailing Address - State:NY
Mailing Address - Zip Code:13803-2111
Mailing Address - Country:US
Mailing Address - Phone:607-345-9122
Mailing Address - Fax:
Practice Address - Street 1:430 W STATE ST STE 205
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5279
Practice Address - Country:US
Practice Address - Phone:607-437-0141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist