Provider Demographics
NPI:1093124539
Name:PARKER, KRISTINE (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1164 FM 211
Mailing Address - Street 2:SUIT D
Mailing Address - City:NEW HOME
Mailing Address - State:TX
Mailing Address - Zip Code:79381-2302
Mailing Address - Country:US
Mailing Address - Phone:806-924-7648
Mailing Address - Fax:
Practice Address - Street 1:1164 FM 211
Practice Address - Street 2:SUIT D
Practice Address - City:NEW HOME
Practice Address - State:TX
Practice Address - Zip Code:79381-2302
Practice Address - Country:US
Practice Address - Phone:806-924-7648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19624235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist