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General NPI Number Information
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NPI Number | 1225843378
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Entity Type | Individual
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Provider Name | REBECCA DANIELLE PARKS M.ED., CF-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 1400 MELBOURNE RD
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-3148
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Country | US
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Telephone | 434-363-0823
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Fax |
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Provider Business Mailing Address
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Address Line | 235 YELLOWSTONE DR APT 103
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-8123
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Country | US
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Telephone | 434-363-0823
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2204001532
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License Number State | VA
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