Provider Demographics
NPI:1689728958
Name:PARKER, GERTRUDE M (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MRS
First Name:GERTRUDE
Middle Name:M
Last Name:PARKER
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:85 WHISPERWOOD BLVD
Mailing Address - Street 2:STE 2P
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1136
Mailing Address - Country:US
Mailing Address - Phone:985-781-8565
Mailing Address - Fax:985-781-5395
Practice Address - Street 1:85 WHISPERWOOD BLVD
Practice Address - Street 2:STE 2P
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-1136
Practice Address - Country:US
Practice Address - Phone:985-781-8565
Practice Address - Fax:985-781-5395
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LALAZ10995225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4C488DW18Medicare PIN