Individual
DEIDRA DAWN PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC/SLP
Contact information
Practice address
16721 E KENDALL RD, MOUNT VERNON, IL 62864-2077
(618) 214-2883
Mailing address
16721 E KENDALL RD, MOUNT VERNON, IL 62864-2077
(618) 214-2883
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.005992
IL
Other
Enumeration date
08/12/2008
Last updated
08/12/2008
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