Basic Information
| Provider Information | |||||||||
| NPI: | 1598893000 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARSONS | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | GAIL | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MA., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 49801 HWY 93 | ||||||||
| Address2: | SUITE A #158 | ||||||||
| City: | POLSON | ||||||||
| State: | MT | ||||||||
| PostalCode: | 59860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8643618729 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9 14TH AVE W | ||||||||
| Address2: | |||||||||
| City: | POLSON | ||||||||
| State: | MT | ||||||||
| PostalCode: | 598605321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4068834378 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2007 | ||||||||
| LastUpdateDate: | 03/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SP829 | WY | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | 2059 | NM | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | SLP-SP-LIC-7299 | MT | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
ID Information
| ID | Type | State | Issuer | Description | 76956 | 05 | NM | MEDICAID |