Provider Demographics
NPI:1962132118
Name:PARISE-KELLEY, DEANNA RENEE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:RENEE
Last Name:PARISE-KELLEY
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 1:4119 AMHURST DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-3199
Mailing Address - Country:US
Mailing Address - Phone:214-662-3928
Mailing Address - Fax:
Practice Address - Street 1:4851 S INTERSTATE 35 E STE 100
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210-2348
Practice Address - Country:US
Practice Address - Phone:940-368-8143
Practice Address - Fax:817-997-4299
Is Sole Proprietor?:No
Enumeration Date:2022-06-11
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101088235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist