Provider Demographics
NPI:1780910711
Name:PARKER, ALISA (OTR/L)
Entity type:Individual
Prefix:MS
First Name:ALISA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ALISA
Other - Middle Name:
Other - Last Name:CHAPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:8584 EDEN ISLES LN
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-6800
Mailing Address - Country:US
Mailing Address - Phone:321-795-6007
Mailing Address - Fax:877-787-5595
Practice Address - Street 1:8584 EDEN ISLES LN
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-6800
Practice Address - Country:US
Practice Address - Phone:321-795-6007
Practice Address - Fax:877-787-5595
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 12728225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist