Provider Demographics
NPI:1568843753
Name:PARKER, LISA (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:PARKER
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 1:395 BISHOP HOLLOW RD
Mailing Address - Street 2:UNIT H
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3233
Mailing Address - Country:US
Mailing Address - Phone:610-356-5566
Mailing Address - Fax:
Practice Address - Street 1:395 BISHOP HOLLOW RD
Practice Address - Street 2:UNIT H
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3233
Practice Address - Country:US
Practice Address - Phone:610-356-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011080225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist