MEDICARE: JOLIE ANNE PARKER M.S., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SA 7772	FL

General Provider Information

NPI Number	:	1356443899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOLIE ANNE PARKER M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	2902 PORTSMOUTH ST
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32738-3127
Country	:	US
Telephone Number	:	863-258-3446
Fax Number	:

Provider Business Practice Location Address
First Line	:	2902 PORTSMOUTH ST
Second Line	:
City	:	DELTONA
State	:	FL
Zip	:	32738-3127
Country	:	US
Telephone Number	:	407-766-8625
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2006
Last Update Date	:	05/02/2019

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Directions to “ JOLIE ANNE PARKER M.S., CCC-SLP” Practice Location

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