Provider Demographics
NPI:1841860368
Name:PARENT, AMELIA ROSE (SLP)
Entity type:Individual
Prefix:MS
First Name:AMELIA
Middle Name:ROSE
Last Name:PARENT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 HARVARD AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-6207
Mailing Address - Country:US
Mailing Address - Phone:802-393-9596
Mailing Address - Fax:
Practice Address - Street 1:110 HARTWELL AVE STE 100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-3118
Practice Address - Country:US
Practice Address - Phone:781-658-3009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78080235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist