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NPI Code Detail

MEDICARE: MRS. JOANN MARIE PARKER M.S., CCC-SP

MEDICARE:  MRS. JOANN MARIE PARKER  M.S., CCC-SP
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
1235Z00000XSpeech-Language Pathologist156-154WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200810796OTHERWIASHA ACCOUNT NUMBER

General Provider Information

NPI Number : 1578605895
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JOANN MARIE PARKER M.S., CCC-SP
Provider Business Mailing Address
First Line : 4141 FARMINGTON LN
Second Line :
City : RACINE
State : WI
Zip : 53403-4083
Country : US
Telephone Number : 262-598-0192
Fax Number :
Provider Business Practice Location Address
First Line : 4214 SHERIDAN RD
Second Line :
City : RACINE
State : WI
Zip : 53403-4142
Country : US
Telephone Number : 262-554-5006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/09/2007

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Directions to “ MRS. JOANN MARIE PARKER M.S., CCC-SP” Practice Location

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