Provider Demographics
NPI:1750009833
Name:PARKER, ANDREA (OTR/L)
Entity type:Individual
Prefix:
First Name:ANDREA
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 1:1 WILLOW WAY
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-3079
Mailing Address - Country:US
Mailing Address - Phone:417-569-3765
Mailing Address - Fax:
Practice Address - Street 1:1001 ROUTE 376
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-6390
Practice Address - Country:US
Practice Address - Phone:845-827-5360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
468323225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist