Provider Demographics
NPI:1487892956
Name:PARKER, AMELIA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7544 METCALF RD
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-8638
Mailing Address - Country:US
Mailing Address - Phone:404-543-6818
Mailing Address - Fax:229-226-6854
Practice Address - Street 1:7544 METCALF RD
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-8638
Practice Address - Country:US
Practice Address - Phone:404-543-6818
Practice Address - Fax:229-226-6854
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003141235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist