Provider Demographics
NPI:1144667106
Name:PARRISH, PATRICE W
Entity type:Individual
Prefix:MRS
First Name:PATRICE
Middle Name:W
Last Name:PARRISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 HERITAGE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-3448
Mailing Address - Country:US
Mailing Address - Phone:864-279-6200
Mailing Address - Fax:
Practice Address - Street 1:451 HERITAGE HILLS DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-3448
Practice Address - Country:US
Practice Address - Phone:864-279-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC206235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC206OtherSOUTH CAROLINA LICENSE IN SPEECH PATHOLOGY