Provider Demographics
NPI:1073271169
Name:PARMENTIER, KATIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:PARMENTIER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 SEVERNVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CROWNSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21032-1131
Mailing Address - Country:US
Mailing Address - Phone:443-926-2582
Mailing Address - Fax:
Practice Address - Street 1:645 BALTIMORE ANNAPOLIS BLVD STE 111
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-3956
Practice Address - Country:US
Practice Address - Phone:410-544-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09498225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist