MEDICARE: ANDREA L PARKER MSP, CCC-SLP

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	922	HI
2	235Z00000X	Speech-Language Pathologist	8234	NC
3	235Z00000X	Speech-Language Pathologist	146009549	IL

General Provider Information

NPI Number	:	1083860555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA L PARKER MSP, CCC-SLP

Provider Business Mailing Address
First Line	:	2911 IRENE BRIDGE HWY
Second Line	:
City	:	HICKORY GROVE
State	:	SC
Zip	:	29717-8776
Country	:	US
Telephone Number	:	704-299-2035
Fax Number	:

Provider Business Practice Location Address
First Line	:	2911 IRENE BRIDGE HWY
Second Line	:
City	:	HICKORY GROVE
State	:	SC
Zip	:	29717-8776
Country	:	US
Telephone Number	:	704-299-2035
Fax Number	:

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

Provider Enumeration Date	:	08/14/2008
Last Update Date	:	08/14/2008

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Directions to “ ANDREA L PARKER MSP, CCC-SLP” Practice Location

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