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General NPI Number Information
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NPI Number | 1437760329
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Entity Type | Individual
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Provider Name | MINA ELIDA PARRISH MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/13/2020
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 154 E MAIN ST
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City | CLARKSBURG
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State | WV
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Zip | 26301-2160
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Country | US
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Telephone | 304-933-3073
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Fax |
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Provider Business Mailing Address
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Address Line | 20 ROBIN LN
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City | MORGANTOWN
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State | WV
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Zip | 26508-4274
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Country | US
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Telephone | 724-889-7387
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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 | 2218
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License Number State | WV
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