Provider Demographics
NPI:1730457409
Name:PARKES, KRISTEN ELYSE (SLPA)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ELYSE
Last Name:PARKES
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 E REDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-8103
Mailing Address - Country:US
Mailing Address - Phone:480-528-8392
Mailing Address - Fax:480-963-8990
Practice Address - Street 1:1680 E REDFIELD RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-8103
Practice Address - Country:US
Practice Address - Phone:480-528-8392
Practice Address - Fax:480-963-8990
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA75362355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant