Healthcare Provider Details

I. General information

NPI: 1285558486
Provider Name (Legal Business Name): PARKE DIXON SPEECH FACTORY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 BUFORD HWY
BUFORD GA
30518-8721
US

IV. Provider business mailing address

3832 HOLLAND DR
SNELLVILLE GA
30039-5950
US

V. Phone/Fax

Practice location:
  • Phone: 404-422-0193
  • Fax:
Mailing address:
  • Phone: 404-422-0193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RENEIDA YVONNE PARKER
Title or Position: OWNER, M.ED., CCC-SLP
Credential:
Phone: 678-249-9956