Provider Demographics
NPI:1225843378
Name:PARKS, REBECCA DANIELLE (MED, CF-SLP)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:DANIELLE
Last Name:PARKS
Suffix:
Gender:F
Credentials:MED, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 YELLOWSTONE DR APT 103
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-8123
Mailing Address - Country:US
Mailing Address - Phone:434-363-0823
Mailing Address - Fax:
Practice Address - Street 1:1400 MELBOURNE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-3148
Practice Address - Country:US
Practice Address - Phone:434-363-0823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204001532235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist