Provider Demographics
NPI:1801420781
Name:PARKER, BLAKENEY
Entity type:Individual
Prefix:
First Name:BLAKENEY
Middle Name:
Last Name:PARKER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:BLAKENEY
Other - Middle Name:
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:652 SNAPDRAGON CT
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1612
Mailing Address - Country:US
Mailing Address - Phone:804-767-0588
Mailing Address - Fax:
Practice Address - Street 1:12 MEDSTAR BLVD STE 352
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-1798
Practice Address - Country:US
Practice Address - Phone:410-877-8078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-28
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09051225X00000X
FL20639225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist