Provider Demographics
NPI:1457599920
Name:PARRIS, ROSHANA ATHENIA (MA,)
Entity type:Individual
Prefix:MRS
First Name:ROSHANA
Middle Name:ATHENIA
Last Name:PARRIS
Suffix:
Gender:F
Credentials:MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8251 SW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-2038
Mailing Address - Country:US
Mailing Address - Phone:954-562-6718
Mailing Address - Fax:
Practice Address - Street 1:5901 BLUE BEECH PL
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-3033
Practice Address - Country:US
Practice Address - Phone:954-562-6718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist