Provider Demographics
NPI:1144779836
Name:PARKER, BRITTANY (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 RIDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-3405
Mailing Address - Country:US
Mailing Address - Phone:505-716-3060
Mailing Address - Fax:
Practice Address - Street 1:2205 RIDGECREST DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-3405
Practice Address - Country:US
Practice Address - Phone:505-716-3060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009021174400000X
COOTA.0000871225XP0200X
NMOT4271225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No174400000XOther Service ProvidersSpecialist