Doctor Name: | CONNIE SUE PARKS |
NPI Number: | 1669745733 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | SA2265 |
Business Practice Address: | 741 S Beneva Rd Sarasota, FL - 342322411 |
Business Phone Number: | 9419570310 |
Business Fax Number: | |
Mailing Address: | 4238 67th Avenue Cir E, SARASOTA |
State: | FL |
Postal Code: | 342435101 |
Phone Number: | 9417568835 |
Fax Number: | |
NPI Enumeration Date: | 02/20/2012 |
NPI Last Update Date: | 02/20/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA2265 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |