Provider Demographics
NPI:1881898799
Name:PARK, EUNICE Y (OTR)
Entity type:Individual
Prefix:MRS
First Name:EUNICE
Middle Name:Y
Last Name:PARK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:EUNICE
Other - Middle Name:Y
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:95-1059 MAHEA ST
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-6593
Mailing Address - Country:US
Mailing Address - Phone:323-236-2221
Mailing Address - Fax:
Practice Address - Street 1:95-1059 MAHEA ST
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-6593
Practice Address - Country:US
Practice Address - Phone:323-236-2221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics