Provider Demographics
NPI:1306458096
Name:MY LIFE OCCUPATIONAL THERAPY SERVICES
Entity type:Organization
Organization Name:MY LIFE OCCUPATIONAL THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:251-824-2515
Mailing Address - Street 1:9420 HIGHWAY 188
Mailing Address - Street 2:SUITE 9
Mailing Address - City:IRVINGTON
Mailing Address - State:AL
Mailing Address - Zip Code:36544-3393
Mailing Address - Country:US
Mailing Address - Phone:251-824-2515
Mailing Address - Fax:251-650-1908
Practice Address - Street 1:9420 HIGHWAY 188
Practice Address - Street 2:SUITE 9
Practice Address - City:IRVINGTON
Practice Address - State:AL
Practice Address - Zip Code:36544-3393
Practice Address - Country:US
Practice Address - Phone:251-824-2515
Practice Address - Fax:251-650-1908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-23
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental ModificationGroup - Multi-Specialty