MEDICARE: ALYSSA C PARKER 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	3529	AR

General Provider Information

NPI Number	:	1639503501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA C PARKER SLP

Provider Business Mailing Address
First Line	:	219 SUSSEX AVE
Second Line	:
City	:	LOWELL
State	:	AR
Zip	:	72745-8895
Country	:	US
Telephone Number	:	870-577-4524
Fax Number	:

Provider Business Practice Location Address
First Line	:	3291 S THOMPSON ST STE F101
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72764-7342
Country	:	US
Telephone Number	:	479-750-3535
Fax Number	:

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

Provider Enumeration Date	:	08/28/2013
Last Update Date	:	07/25/2022

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Directions to “ ALYSSA C PARKER SLP” Practice Location

Language	Start Address	Practice Location

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