Provider Demographics
NPI:1356567382
Name:PARKER, KATHERINE LINCOLN (MSPT, PCS)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LINCOLN
Last Name:PARKER
Suffix:
Gender:F
Credentials:MSPT, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4849 A SOUTH 28TH STREET
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-1365
Mailing Address - Country:US
Mailing Address - Phone:703-931-7674
Mailing Address - Fax:703-931-7674
Practice Address - Street 1:4849 A SOUTH 28TH STREET
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-1365
Practice Address - Country:US
Practice Address - Phone:703-931-7674
Practice Address - Fax:703-931-7674
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT20742251P0200X
VA23050033682251P0200X
MD162892251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
S3800001OtherBCBS ID NUMBER