Provider Demographics
NPI:1588343172
Name:PARKER-KABANA, PAULA LYNNE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:LYNNE
Last Name:PARKER-KABANA
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 1:9000 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-8373
Mailing Address - Country:US
Mailing Address - Phone:810-656-0193
Mailing Address - Fax:
Practice Address - Street 1:219 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-1431
Practice Address - Country:US
Practice Address - Phone:810-412-4573
Practice Address - Fax:810-412-5864
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty