Individual
MRS. JOANN MARIE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SP
Contact information
Practice address
4214 SHERIDAN RD, RACINE, WI 53403-4142
(262) 554-5006
Mailing address
4141 FARMINGTON LN, RACINE, WI 53403-4083
(262) 598-0192
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
156-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00810796
ASHA ACCOUNT NUMBER
WI
05
—
42660700
—
WI
Enumeration date
02/13/2007
Last updated
07/09/2007
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