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NPI Code Detail

MEDICARE: MARY GRACE PARKS

MEDICARE: MARY GRACE PARKS
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
1235Z00000XSpeech-Language Pathologist9903LA

General Provider Information

NPI Number : 1770411340
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY GRACE PARKS
Provider Business Mailing Address
First Line : 269 HOLLYWOOD DR
Second Line :
City : METAIRIE
State : LA
Zip : 70005-3919
Country : US
Telephone Number : 504-875-6735
Fax Number :
Provider Business Practice Location Address
First Line : 664 ROSA AVE
Second Line :
City : METAIRIE
State : LA
Zip : 70005-2849
Country : US
Telephone Number : 504-875-6735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2026
Last Update Date : 05/12/2026

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Directions to “ MARY GRACE PARKS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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