Provider Demographics
NPI:1700109261
Name:PARRELL MASON, DENA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DENA
Middle Name:
Last Name:PARRELL MASON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14423 68TH RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1330
Mailing Address - Country:US
Mailing Address - Phone:718-793-3790
Mailing Address - Fax:
Practice Address - Street 1:14423 68TH RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1330
Practice Address - Country:US
Practice Address - Phone:718-793-3790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011139235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist