Provider Demographics
NPI:1326286352
Name:PARKER, JODY (OTR)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2918 PYRAMID AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-2510
Mailing Address - Country:US
Mailing Address - Phone:724-689-7797
Mailing Address - Fax:
Practice Address - Street 1:2918 PYRAMID AVE
Practice Address - Street 2:APT 2
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-2510
Practice Address - Country:US
Practice Address - Phone:724-689-7797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-29
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0C010877225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist