MEDICARE: JAMEKA PARKER

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
1	235Z00000X	Speech-Language Pathologist	08252	MD
2	235Z00000X	Speech-Language Pathologist	SLP001124	DC

General Provider Information

NPI Number	:	1023558970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMEKA PARKER

Provider Business Mailing Address
First Line	:	5500 LANGLEY WAY SW APT C
Second Line	:
City	:	BOLLING AFB
State	:	DC
Zip	:	20032-7619
Country	:	US
Telephone Number	:	318-789-9797
Fax Number	:

Provider Business Practice Location Address
First Line	:	5500 LANGLEY WAY SW APT C
Second Line	:
City	:	BOLLING AFB
State	:	DC
Zip	:	20032-7619
Country	:	US
Telephone Number	:	318-789-9797
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2017
Last Update Date	:	02/26/2017

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Directions to “ JAMEKA PARKER ” Practice Location

Language	Start Address	Practice Location

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