Provider Demographics
NPI:1821668559
Name:ANDERSON, PARKER ELIAS LEE (BA,RBT)
Entity Type:Individual
Prefix:
First Name:PARKER
Middle Name:ELIAS LEE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:BA,RBT
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:ELIZABETH
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:701 LOYOLA AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70113-1912
Mailing Address - Country:US
Mailing Address - Phone:504-584-8757
Mailing Address - Fax:
Practice Address - Street 1:2407 BARONNE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-1621
Practice Address - Country:US
Practice Address - Phone:504-584-8757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator