Healthcare Provider Details

I. General information

NPI: 1609425982
Provider Name (Legal Business Name): ANDREA PARRY MS-SLP, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 W SOUTHERN AVE STE B
MESA AZ
85202-4716
US

IV. Provider business mailing address

2225 W SOUTHERN AVE STE B
MESA AZ
85202-4716
US

V. Phone/Fax

Practice location:
  • Phone: 480-462-3880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP9248
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: