Basic Information
| Provider Information | |||||||||
| NPI: | 1053655050 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARKER | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14286 BEACH BLVD | ||||||||
| Address2: | SUITE 34 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322501561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043457512 | ||||||||
| FaxNumber: | 9043457540 | ||||||||
| Practice Location | |||||||||
| Address1: | 14286 BEACH BLVD | ||||||||
| Address2: | SUITE 34 | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322501561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043457512 | ||||||||
| FaxNumber: | 9043457540 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2012 | ||||||||
| LastUpdateDate: | 07/27/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 2012038834 | MO | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | SA 13154 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.