MEDICARE: JESSICA G 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	06588	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790811495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA G PARKER SLP

Provider Business Mailing Address
First Line	:	17830 NEW HAMPSHIRE AVE STE 300
Second Line	:
City	:	ASHTON
State	:	MD
Zip	:	20861-3644
Country	:	US
Telephone Number	:	301-323-8486
Fax Number	:	240-422-8283

Provider Business Practice Location Address
First Line	:	17830 NEW HAMPSHIRE AVE STE 300
Second Line	:
City	:	ASHTON
State	:	MD
Zip	:	20861-3644
Country	:	US
Telephone Number	:	301-323-8486
Fax Number	:	240-422-8283

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	10/26/2021

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Directions to “ JESSICA G PARKER SLP” Practice Location

Language	Start Address	Practice Location

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