Provider Demographics
NPI:1457956880
Name:PARKER, LILLIE SENORIA (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:LILLIE
Middle Name:SENORIA
Last Name:PARKER
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 BELL ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23661-1403
Mailing Address - Country:US
Mailing Address - Phone:757-727-1071
Mailing Address - Fax:
Practice Address - Street 1:671 BELL ST
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23661-1403
Practice Address - Country:US
Practice Address - Phone:757-727-1071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000574235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist