Provider Demographics
NPI:1053506733
Name:PARNELL, LISA WRIGHT (OTR/L, CLT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:WRIGHT
Last Name:PARNELL
Suffix:
Gender:F
Credentials:OTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7670 KEN BUCK RD
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:AL
Mailing Address - Zip Code:36544-4146
Mailing Address - Country:US
Mailing Address - Phone:251-604-5489
Mailing Address - Fax:
Practice Address - Street 1:3956 GOVERNMENT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-4723
Practice Address - Country:US
Practice Address - Phone:251-604-5489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2755225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist